BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests

Tumor necrosis factor-n (TNF - alpha) involved in the pathogenesis of multiple sclerosis and contribute to the degeneration of oligodendrocytes as well as neurons. TNF - alpha is produced by miocroglia and astrocytes, which also produce hormones and cytokines that influence its biological activity. Astrocytes, the major glial cells in the CNS, are capable of producing TNF - alpha at both the mRNA and protein levels in response to interleukine-1 (IL-1) or TNF - alpha. Two immunosuppressive cytokines, transforming growth factor - beta (TGF - beta) and IL-10, have been shown to influence glial cell function. TGF - beta can modulate the activity of glial cells by inhibiting interferon-gamma (IFN - gamma) induced expression of class II major histocompatibility complex (MHC) molecules on astrocytes and microglia. To explore the role of astrocytes in the production of TNF - alpha, astrocytes were pretreated with IL-10 or TGF - beta and then stimulated with IL-1p to determine their effects on TNF - alpha production. The secretion of TNF - alpha by human fetal astrocytes was markedly inhibited by TGF - beta at a low concentration. In contrast IL-10 had no effect on TNF - alpha mRNA level. These results show that TGF - beta may regulate the expression of TNF - alpha in activated human fetal astrocytes.
Astrocytes* ; Cytokines ; Gene Expression* ; Humans* ; Interferon-gamma ; Interleukin-10 ; Major Histocompatibility Complex ; Microglia ; Multiple Sclerosis ; Necrosis ; Neuroglia ; Neurons ; Oligodendroglia ; RNA, Messenger ; Transforming Growth Factors

Airway hyperresponsiveness is a consistent feature of asthma. Since the airway smooth muscle is hyperresponsive to a number of different stimuli operating through many different mechanisms, it is attractive to speculate that the abnormality may reside in the airway smooth muscle itself. Animal model of asthma is needed to unravel possible mechanisms underlying airway hyperresponsiveness and also to develop new therapeutic approaches. However, there are few reports showing that airway smooth muscle from animal asthma model is indeed hyperresponsive. In addition, sensitizing and provoking doses of allergen were different each other ambng the studies on animal asthma model. The aim of this study was to determine an appropriate sensitizing and provoking dose of allergen to induce a maximum airway hyperresponsiveness. Eighty-four male Sprague-Dawley rats were actively sensitized with a subcutaneous injection of 0, 10, or 1000/gg ovalbumin(OA) and 14 days later they were provoked with 0, 1, or 5 % OA aerosols. One day after the provocation, serum levels of OA-specific IgE, cell numbers in bronchoalveolar lavage fluid (BALF), and in vitro isometric contractile responses of the isolated tracheal smooth muscle(TSM) to 120 mM KC1, acetylcholine(ACh, 0.1~ 1000/micro meter), electrical field stimulation (EFS, 0.5~100Hz), serotonin(5-HT, 0.014 100/micro meter), and OA(10, 50, or 250 micro gram/ml) were measured. The results were as follows; 1) When 38 OA-sensitized rats were exposed to OA aerosols in vivo early asthmatic responses(EAR) were observed in 20(52.6%) rats. In vitro isometric contractile forces of TSM from rats with EAR were stronger than those from rats without EAR. 2) The maximal contractile responses to KC1 and EFS were significantly higher in rats only sensitized with OA compared with those in controls. The maximal response to ACh was significantly related to OA-specific serum IgE level(r=0.40, p%0.05), and the latter was in turn significantly related to the BALF eosinophil count(r=0.67, p<0.01). 3) When 10 microgram OA-sensitized rats were analyzed, the maximal response to KC1, ACh, EFS, and 250 micro gram/ml OA were lower in OA-provoked rats compared to those in saline-provoked control rats, in which 5% OA-provoked rats had a lower response than 1% OA-provoked rats. 4) The sensitivity of TSM to ACh was significantly higher in 10/micro gram OA-sensitized & OA-provoked rats, and the sensitivity to EFS was also significantly higher in 10/~g OA-sensitized & 5% OA-provoked rats compared to that in controls(p<0.05). 5) There was a significant correlation between the sensitivity of TSM to EFS and the counts of eosinophil or of lymphocytes in BALF(for eosinophil, r=-0.30; p<0.05, for lymphocyte, r=-0.35; p<0.05), or OA-specific serum IgE level(r=-0.46, p<0.01) in OA-sensitized & OA-provoked rats. This relationship was maintained in the data obtained only from 10 micro gram OA-sensitized & 5% OA-provoked rats. 6) The ratio of EFS-sensitivity to ACh-sensitivity was significantly lower in OA-sensitized & OA-provoked rats compared to that in controls or rats only sensitized with OA(p%0.05). 7) The Schultz-Dale phenomenon occurred in an in vitro dose-dependent manner. However, the inhaled provocation with OA in vivo resulted in a decrease in the contractile response to OA in vitro. There was a significant correlation between OA-specific serum IgE level and isometric response to 250 micro gram/ml OA(r=0.36, p<0.01). These results suggest that sensitization and provocation in vivo with OA in rats induces hypersensitivity of airway smooth muscle to cholinergic stimuli through an allergic inflammatory mechanism. The sensitivity was highest when sensitized to 10 micro gram OA and exposed to 5% OA aerosols.
Aerosols ; Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Cell Count ; Ear ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Injections, Subcutaneous ; Lymphocytes ; Male ; Models, Animal ; Muscle, Smooth* ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To establish new in vitro model systems that better reflect in vivo condition, multicellular tumor spheroids(MTS) and raft culture were developed using cell lines of squamous cell carcinoma(SCCHN) of the head and neck. In these 3-dimensional systems, the expression of cell surface molecules which are important for modulation of physiology of tumor cells were studied with or without the treatment of interferon(IFN)-gamma. MATERIALS AND METHODS: Four SCCHN cell lines were used for MTS and raft culture. The effects of interferon-gamma on SCCHN cells were examined by immunohistochemistry. RESULTS: All cell lines formed MTS, but only Tu-138 showed a good stratification at the air-liquid interface in the raft culture system. Immunohistochemical studies of MTS using monoclonal antibodies revealed a strong staining for MHC class I, no staining for MHC-DR, a weak patch expression of ICAM-1 and a central strong staining for integrin a 6. Staining patterns were similar for the raft cultures except integrin a 6(intense full-thickness positivity). In both systems, IFN-gamma enhanced the expression of MHC-DR and ICAM-1. No significant change was found in the expression of MHC class I and integrin a 6. CONCLUSIONS: MTS and raft culture system were established successfully from the SCCHN cell lines. IFN-gamma can modulate the surface molecules of tumor cells in the 3-dimensional culture systems.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Cell Line ; Head* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Interferon-gamma ; Neck* ; Physiology

No abstract available.
Astrocytes* ; Gene Expression* ; Humans* ; Polymerase Chain Reaction*

No abstract available.
Astrocytes* ; Humans*

No abstract available.
Jaundice

The effects of intravenous Verapamil administration on ventricular function were evaluated using grated radionuclide ventriculography in 15 patients with essential hypertension. Verapamil(0.1mg/kg) was injected as a bolus for 2 minutes followed by an infusion of 0.007mg/kg/min. Heart rate, blood pressure, ejection fraction, peak ejection rate, total filling time, and prak filling rate were assessed before and after Verapamil administration. The results were was as follows ; 1) Verapamil administration increased heart rate from 63+/-5 to 75+/-9 beats/min(p<0.01) and reduced systolic and diastolic blood pressure from 156+/-17/99+/-6mmHg to 139+/-16/88+/-6mmHg(p<0.01). 2) Ejection fraction, peak ejection rate, and total filling time were not changed significantly after Verapamil injection. 3) Right and left ventricular peak filling rate increased significantly only in patients in whom it was subnormal in the basal study) from 1.6+/-0.4 to 2.3+/-1.1 end-diastolic volumes/s, p<0.05 and from 2.5+/-0.6 to 3.1+/-0.8 end-diastolic volumes/s, p<0.05, respectively). In conclusion, it was found that intravenous Verapamil administration enhances ventricular diatolic function in patients with essential hypertension.
Blood Pressure ; Heart Rate ; Humans ; Hypertension* ; Radionuclide Ventriculography ; Ventricular Function ; Ventricular Function, Right* ; Verapamil*

PURPOSE: We report a case of cryotherapy for fungal corneal ulcers that did not respond to antifungal agents. CASE SUMMARY: A 58-year-old man was transferred to our hospital with a left eye corneal ulcer due to pain and visual impairment in his left eye for two weeks, and he was suspected to have a history of fungal infection. At the time of admission, corneal opacity and progressive ulcerative lesions were observed at 5 o'clock in the left eye and visual acuity was 0.025, uncorrected. The corneal ulcer marginal resection, bacterial culture, and potassium hydroxide preparation (KOH) test were performed on lesion sites. Cultures of Candida albicans were reported to grow, topical antibiotics (Fortified tobramycin, Fortified cefazolin, moxifloxacin), and anti-fungal agents (fortified amphotericin B, 0.5%, Natamycin) were administered, but no improvement was observed for 2 weeks. On the 14th day after admission, Cryotherapy was performed. After surgery, eye drops were equally applied, and there was no other discomfort other than pain for 3 days after the operation. He discharged 10 days after surgery, the corneal lesion was healed and the visual acuity was improved to 0.32, uncorrected. CONCLUSIONS: We report a case of cryotherapy for fungal corneal ulcers that did not react with topical antifungal drugs and improved visual acuity and symptom improvement.
Amphotericin B ; Anti-Bacterial Agents ; Antifungal Agents ; Candida albicans ; Cefazolin ; Corneal Opacity ; Corneal Ulcer* ; Cryotherapy* ; Humans ; Middle Aged ; Ophthalmic Solutions ; Potassium ; Tobramycin ; Ulcer ; Vision Disorders ; Visual Acuity

BACKGROUND: Atlanto-axial dislocation (AAD) is a common complication of rheumatoid arthritis (RA). Diverse or different patterns of neurological manifestations including brainstem signs, myelopathy, vertebrobasilar insufficiency, and radiculopathy are expected in each type of AAD. This study is designed for the evaluation of neurological manifes-tations of AAD in RA, and for the comparison of clinical profiles with radiological findings. METHODS: Thirty patients compatible with radiological criteria of AAD were selected. The age, sex, symptom duration, and neurological signs were evaluated in the clinical profiles. Based on the neurological signs, the patients were classified into three groups. Radiological classifications of AAD were done according to the direction of AAD (anterior, vertical, lateral, mixed) and degrees of dislocation (grade I, II, III). Correlational analysis was performed as a measure of association with the clinical profiles and radiological findings. RESULTS: Neurological manifestations were present/found in 50% of the patients. Each types of AAD were distributed into the following groups:; anterior - 76.7%, mixed - 13.3%, lateral -10%, pure vertical - 0% in our study. The various groups determined by the neurological signs may be correlated with the severity of AAD, especially in the anterior type (> 8mm) and mixed type. Neurological signs were not noted in the pure lateral type. Vascular signs such as vertebrobasilar insufficiency (VBI) were more common in the anterior-AAD, but myelopathic or brainstem signs were more common in the mixed type. CONCLUSIONS: Diverse neurological findings exist in AAD. Different and characteristic manifestations are also noted in each type of AAD. Critical neurological signs including myelopathic, brainstem signs and VBI are prominent in severe anterior-AAD or mixed type.
Arthritis, Rheumatoid* ; Brain Stem ; Classification ; Dislocations ; Humans ; Neurologic Manifestations* ; Radiculopathy ; Spinal Cord Diseases ; Vertebrobasilar Insufficiency