Capsaicin, the pungent principle of hot peppers, is a neurotoxin that depletes unmyelinated primary sensory neurons (polymodal nociceptors) of neuropeptides like tachykinins. However, the role of capsaicin-sensitive sensory nerve in the production of cytokines, penicillin V (PEV)-induced active fatal anaphylaxis and other immune responses is not yet fully established. Neonatal mice were pretreated s.c. with a single injection of 10 ug of capsaicin per mouse in volume of 20 ul within 5 days of age. Using 5-8 week old mice pretreated as neonates with capsaicin, the capsaicin- pretreated and vehicle-treated control mice were examined for various parameters of immune responses described above. For the induction of active fatal anaphylaxis with PEV, 8 week old mice pretreated as neonates and age-matched capsaicin- untreated control mice were sensitized i.p. with 500 ug of PEV-ovalbumin conjugate plus 2*10(9) B. pertussis and 1.0 mg alum and challenged i.v. with PEV-bovine serum albumin conjugate 14 days later. It was found that neonatal capsaicin-pretreatment significantly enhanced contact hypersensitivity to TNCB and hemagglutination response to SRBC, but significantly inhibited the proliferation response of rnurine splenocyte to Con A and LPS. Interestingly, neonatal capsaicin pretreatment significantly inhibited the intensity of PEV-induced active fatal anaphylaxis and decreased the mortality due to anaphylactic shock. It also significantly inhibited LPS- induced production of cytokines such as TNF-a, IL-1B, IL-6, IL-10, and IL-12. The capsaicin-pretreatment also resulted in an inhibition of the activation of NF-kB. Taken together, these data showed for the first time that neonatal capsaicin-pretreatment significantly inhibited an antibiotic (PEV)-induced anaphylaxis and production of various cytokines, and suggest that capsaicin-sensitive primary sensory nerve may play an important regulatory role in active fatal anaphylaxis and cytokine production, thus potentially presenting tools for immune intervention. In particular, the data presented also indicated the possibility to selectively down-modulate cytokine production and NF-kB activation may offer a broad application for therapeutic intervention in neuroimmunological diseases and other pathological situations.
Anaphylaxis ; Animals ; Capsaicin* ; Cytokines ; Denervation* ; Dermatitis, Contact ; Hemagglutination ; Humans ; Infant, Newborn ; Interleukin-10 ; Interleukin-12 ; Interleukin-6 ; Mice ; Mortality ; Neuropeptides ; NF-kappa B ; Penicillin V ; Sensory Receptor Cells ; Serum Albumin ; Tachykinins ; Whooping Cough

No abstract available.
Diagnosis* ; Gynecology* ; Laparoscopy*

No abstract available.
Methotrexate*

The mortality rate of aneurysmal surgery had recently been reduced due to modern microsurgical technique and refinement of the timing of operation. Despite recovery without neurological deficits, many patients remain with emotional and psychological sequelae postoperatively. We evaluated 33 patients, operated on intracranial aneurysm for recent 2 years, about quality of life and degree of cognitive function. For proper evaluation of outcome of aneurysmal surgery, in addition to the neurological outcome, psychological aspects must be considered.
Aneurysm ; Humans ; Intracranial Aneurysm* ; Mortality ; Quality of Life

This report describes two cases of complete heart block associated with acute myocarditis. Both cases developed Adams-Stokes attack. One patients was considered to be due to viral infection as judged by clinical course and the other patient was confirmed as Korean hemorrhagic fever by indirect immunofluorescent antibody test. Both cases improved during about 4 weeks admission without sequelae with general supportive treatment only.
Heart Block* ; Heart* ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Myocarditis*

A 59-year-old woman was admitted to our hospital because of occipital headache and multiple cranial nerve dysfunction. The patient had been suffered from chronic otitis media. MRI of the brain showed a thickened and markedly enhanced dura mater in the temporal lobe. The patient underwent a left temporal craniectomy and dural biopsy. Histopathological examination revealed thickened duar amter infiltrated with giant cell, lymphocytic and plasma cell infiltration. The fungus, acid-fast and PAS stains were all negative. After administraion of steroid, cranial nerve disturbances and headache improved. The cause of the hypertrophpic intracranial pachymeningitis in this patient was thought to be related with the chronic otitis media, although the clinical course of the patient was similar to the idiopathic hypertrophic pachymeningitis.
Biopsy ; Brain ; Coloring Agents ; Cranial Nerves ; Dura Mater ; Female ; Fungi ; Giant Cells ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Middle Aged ; Otitis Media* ; Otitis* ; Plasma Cells ; Temporal Lobe

PURPOSE: The purpose of this study was to evalulate the usefulness of internal fixation with two modified Steinmann pins and tension band wiring in displaced proximal humeral fracture. MATERIALS AND METHODS: Thirteen cases of displaced proximal humeral fracture were surgically treated with modified Steinmann pins and tension band wiring and followed for an average 24.9 (6-39) months. Male to female ratio was 6 to 7. Average age was 58.1 (39-81) years. Results were assessed using Neer's evaluation criteria. RESULTS: Excellent results were noted in 9 cases and satisfactory results in 4 cases. All cases obtained radiological union. There was no complication such as avascular necrosis of humeral head or metal failure. Two cases showed impingement syndrome of the proximal portions of Steinmann pins, which were managed by early removal of the metal after union. CONCLUSIONS: Internal fixation using modified Steinmann pins and tension band wiring for proximal humeral fracture minimizes perioperative soft tissue damage, has a low risk of complications, and enables early rehabilitation by rendering relatively rigid fixation.
Female ; Humans ; Humeral Head ; Male ; Necrosis ; Rehabilitation ; Shoulder Fractures*

PURPOSE: The purpose of this study is to compare treatment response and survival according to treatment modalities, such as allogeneic bone marrow transplantation (BMT), combined immunosuppression and supportive care, and according to etiologies in children with severe aplastic anemia. METHODS: Thirty-four patients who had severe aplastic anemia received either BMT, combined immunosuppression, or androgen treatment at Chonnam University Hospital from Jan. 1990 to Mar. 1998. The clinical characteristics and response according to treatment modalities or etiologies were studied retrospectively. RESULTS: 1) Patients in Group 1 received combined immunosuppression of ALG/ATG+methylprednisolone+/-cyclosporin (N=18); Group 2, BMT (N=11); Group 3, supportive treatment of oxymetholone+prednisolone+transfusion (N=5). Clinical characteristics were not different among three groups. 2) In Group 1, the response rate was 50% with complete response (CR) in 4 (22.2%) and partial response (PR) in 5 (27.8%). CR was attained in 91% (10/11) of Group 2 patients, while all 5 in Group 3 were died. Relapse was found in 1 out of 9 (11.1%) in Group 1. Three of 10 in Group 2 who had initial response experienced late graft failure. The Kaplan-Meier 4-year-survival in each group was 75.5%, 81.8% and 20%, respectively (P = 0.019). 3) Among 5 patients were Fanconi's anemia, two survived who underwent HLA- matched sibling transplants. Three patients with secondary aplastic anemia, including posthepatitis (N=2) and post-rubella responded to either BMT or immune suppression. Idiopathic cases (N=26) showed response rate of 43.8% to immunosuppression [CR, 3/16; PR 4/16], 85.7% to BMT, and 0% to supportive care. 4) The relative risk of death was 0.26 (P = 0.052) in Group 1, and 0.15 (P = 0.03) in Group 2 in comparison with Group 3. CONCLUSION: The study showed that BMT and combined immunosuppression resulted in better response and survival than supportive care in the management of childhood severe aplastic anemia. Although BMT seemed to be better than immunosuppression, effective measure to reduce late graft failure and graft versus host disease should be pursued.
Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Child ; Fanconi Anemia ; Graft vs Host Disease ; Humans ; Immunosuppression ; Jeollanam-do ; Recurrence ; Retrospective Studies ; Siblings ; Transplants

OBJECTIVE: This study was organized to find out whether there are differences between pregravid weight, body mass index, weight gain during pregnancy and birth weight in 1989 and 1999. Also it was designed to find out the factors which influenced the birth weight changes. METHODS: A total of 725 (313 in 1989, 412 in 1999) pregnant women who had term delivery in the department of Obstetrics and Gynecology, Hanyang University Hospital were recruited for the study. Pregravid weight, body mass index, weight gain during pregnancy, body weight at the time of delivery and birth weight were examined through medical records retrospectively. RESULTS: Pregnant women in 1999 were older (29.7 +/- 3.7 yr vs 28.3 +/- 3.2 yr, p=0.0001), pregravid weight (54.0 +/- 7.5 kg vs 50.7 +/- 5.5 kg, p=0.0001), height (159.6 +/- 4.8 cm vs 158.5 +/- 4.7 cm, p=0.002), body mass index (21.2 +/- 2.8 kg/m2 vs 20.2 +/- 2.1 kg/m2, p=0.0001), weight gain during pregnancy (13.6 +/- 4.8 kg vs 12.8 +/- 4.6 kg, p=0.016) and birth weight (3103 +/- 652 gm vs 2993 +/- 843 gm, p=0.025) compared with those in 1989. The frequency of overweight (BMI>26) in pregravid was significantly higher in 1999 (9.4%) than in 1989 (1.9%) (p=0.0001). Weight gain during pregnancy were lower in over-weight pregravid than in normal or under-weight pregravid in both year, but birth weight was not different according to pregravid weight in both years. Compared to the weight gain during pregnancy less than 16 kg, women who gained weight more than 16 kg during pregnancy were significantly taller and weighed more at the time of delivery, and showed increased birth weight than those who gained weight during pregnancy less than 16 kg in both years. Weight gain during pregnancy was higher in over-weight pregravid than normal or under-weight pregravid in 1999 (p=0.012). The gain of body weight at the time of delivery in 1999 compared to those in 1989 is the most important factor for the birth weight change between two years. The increased pregravid weight, greater weight gain during pregnancy, and increased BMI also had an impact on the increasing birth weight in 1999. CONCLUSION: It is considered that physical characteristics of pregnant women in 1999 have been changed compared to those in 1989, and this change might be responsible for a birth weight increase.
Birth Weight ; Body Mass Index ; Body Weight ; Female ; Gynecology ; Humans ; Medical Records ; Obstetrics ; Overweight ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Weight Gain ; Weights and Measures*