Bone remodeling is characterized by the coupling of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. The process is tightly regualted at the local level by an incompletely known netwotk of peptide and non-peptide fators. Nitric oxide(NO), synthesized by nitric oxide synthetase(NOS) from L-arginine, is becoming recognized as an important bioregualtory molecule in a variety of tissue, but little is known about its possible role in periodontal tissue. The purpose of this study is to investigate the expression of nitric oxide synthetase(NOS) in inflamed gingiva and the effects of cytokine on the expression of NOS protein. The expression of NOS in gingival tissue was evaluated by immunohistochemical staining for NOS1, NOS2, NOS3. The effect of cytokine on the expression of NOS in human periodontal ligament cells and osteoblast-like HOS cells by western blot analysis. Further, we studied that NO functions in periodontal ligment cells as a regulatory molecule. PDL cells incubated with NOS inhibitor and donor. The protein expression, type I collagen & non-collagenous protein, nitrate production and cell proliferation were evaluated The results were as follows. 1. NOS1, NOS2, NOS3 was rarely distributed in healthy gingiva, but stronger stained in gingival epithelium, endothelial cells, and mononuclear cells of inflammed gingiva. 2. The cytokine stimulated NOS1, and NOS3 protein were not inducing or inhibitory effect to compared with control in PDL and HOS cells. 3.Incubation of cells with combination of TNF-alpha, IFN-gamma, LPS result in a time dependant increase in NOS2 expression, reaching a maximal level after 24 hours of stimulation. 4. The osteonectin protein inhibitory effect of NMA, inhibitor of NOS, was reversed by Larginine in dose dependant manner. 5. NMA decreased cell proliferation and nitrate production, but the inhibitory efffect of NMA was also prevented by the NO donor, sodium nitropruiside. These results suggest that exogenously synthesized NO was playing a stimulating effect on cell proliferation or on non-collagenous protein expression. Therefore NO have an important role in mediation of localized bone destruction associated inflammatory bone disease such as periodontitis
Arginine ; Blotting, Western ; Bone Diseases ; Bone Remodeling ; Bone Resorption ; Cell Proliferation ; Collagen Type I ; Endothelial Cells ; Epithelium ; Gingiva ; Humans ; Negotiating ; Nitric Oxide Synthase* ; Nitric Oxide* ; Osteogenesis ; Osteonectin ; Periodontal Ligament ; Periodontitis ; Sensitivity and Specificity* ; Sodium ; Tissue Donors ; Tumor Necrosis Factor-alpha

We observed a 51-year-old male, who developed depigmented patches on the lower abdomen after photochemotherapy(PUVA) of psoriasis without evidence of phototoxic reaction. The depigmented patches did not orginate from the sites of previous psoriatic lesions. Fontana-Masson stain of the biopsy specimen revealed nearly absent melanin pigments in the epidrmis of the hypopigmented patch, while lots of pigments were obsereved on the surrounding hyperpigmented area. Electron micrograph showed no melanocytes in the hypopigmented patch. Thus we report this case as having vitiliginous patches induced by photochemotherapy of psoriasis.
Abdomen ; Biopsy ; Humans ; Male ; Melanins ; Melanocytes ; Middle Aged ; Photochemotherapy* ; Psoriasis* ; Vitiligo

PURPOSE: To investigate which spectral domain optical coherence tomography (SD-OCT) findings predict visual outcome after anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (NV-AMD). METHODS: We reviewed the medical records of patients with treatment-naive NV-AMD who underwent three or more consecutive anti-VEGF injections. The patients were divided into three groups according to their changes of visual acuity (VA); improved (group I), static (group S), or worsened (group W). We assessed the incidences and values of all available SD-OCT findings of these groups, compared these findings between the three groups and compared the initial values with the post-treatment values. RESULTS: Better initial VA and longer external limiting membrane (ELM) length were associated with less change in VA after anti-VEGF treatment. The initial VA was mildly correlated with initial photoreceptor inner and outer segment junction (IS/OS) length and initial ELM length. The final VA was also mildly correlated with the final IS/OS length and the final ELM length. VA was significantly changed after anti-VEGF treatment in groups W and I. With regard to incidence, disruption of the IS/OS (IS/OS-D), disruption of the ELM (ELM-D) and ELM length differed significantly between the three groups, particularly ELM-D. The incidences of IS/OS-D and ELM-D in group I were significantly lower than those in groups S and W, and those in group S were also lower than those in group W. The ELM length in group I was significantly longer than it was in groups S and W, and the ELM length in group S was longer than that for group W. However, these three findings did not change after the anti-VEGF treatment. CONCLUSIONS: Initial IS/OS-D, ELM length and particularly ELM-D can be useful predictors of the visual outcome after anti-VEGF treatment in NV-AMD patients.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*therapeutic use ; Choroidal Neovascularization/*drug therapy/physiopathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Ranibizumab/*therapeutic use ; Retinal Photoreceptor Cell Inner Segment/pathology ; Retinal Photoreceptor Cell Outer Segment/pathology ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/*physiology ; Wet Macular Degeneration/*drug therapy/physiopathology

No abstract available.
Bursitis*

Fractures of the tibia are frequently encountered in mordern civilized society. Especially, those in distal 1/3 of the tibia have so many problems, such as angular deformity, osteomyelitis and nonunion because of anatomically scanty soft tissue. Many modalities of the treatment of fracture of distal 1/3 of the tibia were introduced. Among them, interlocking IM nailings were considered as one of the best modality. But, in interlocking IM nail, reaming of the medullary canal which destroys the endosteal circulation and causes thermal necrosis of the inner aspect of the cortical bone results in delayed union. And also, procedure for distal screw fixation is difficult and time-consuming. As for using flexible IM nails for fractures of distal 1/3 of the tibia, it was considered as not so satisfactory method due to lack of stability of fixation. However, the stability of fixation can be strengthened with fanning of the nails in distal fragment, using more than 3 nails and delay the protected weight bearing. Authors studied 25 cases of fractures of distal 1/3 of the tibia treated with closed flexible IM nailing at Sung Ae General Hospital, from July., 1987 to July., 1989, and obtained following results: 1. Among 25 cases, 4th decades were most common and males were more commonly involved. 2. Traffic accidents were the most common causes of injury and majority of 16 open fractures and 19 comminuted fractures, were caused by high energy mechanism. Among open fractures, type II were most common. 3. Two angular deformities less than 10 degrees, one proximal migration and one checkrein deformity were observed as complications, but, no clinically significant complications were noted. 4. The time for radiological union were 14.5 weeks in group without fibular fracture and 15.1 weeks in group with fibular fracture, and 14.0 weeks in closed fracture group and 17.2 weeks in open fracture group, and average in 15.6 weeks.
Accidents, Traffic ; Clinical Study ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Necrosis ; Osteomyelitis ; Tibia ; Weight-Bearing

This study was performed to investigate the clinical efficacy of intralesional recombinant interferon-γ (IFN-γ) in the treatments of warts, using a placebo comparison. Warts of each groups were injected with INF-γ containing 5×10⁶ IU/ml (high dose), 1×10⁶ IU/ml (low dose), or distilled water for injection as placebo, respectively, twice weekly for three weeks. The final therapeutic efficacy was determined on the fourth week after the beginning of therapy. Among the 74 patients with periungual warts, plantar warts, or warts of other sites, complete clearing of the treated warts at week four occurred in 56% of the 36 patients receiving the high dose IFN-γ compared to 30% of the 53 receiving the low dose IFN-γ and 17% of the 36 receiving the placebo. Marked improvement showing 75% or greater regression of wart lesions was noted as 89% of patients receiving the high dose INE compared with 55% receiving the low dose IFN and 50% receiving the placebo. The group of patients with warts of other sites showed the best response. The group receiving the high dose IFN experienced some adverse effects more frequently or more severely than the group receiving low dose IFN. However, the effects were relatively tolerable to the patients. Therefore, intralesional injection of the high dose IFN-γ may be more useful in treating warts than a low dose IFN-γ.
Humans ; Injections, Intralesional ; Interferon-gamma* ; Treatment Outcome ; Warts* ; Water

We have encountered a rare case of erythema nodosum-like leukemia cutis associated with acute myelocytic leukemia(AML) in a 57-year-old male. He was in good health until about 2 weeks prior to admission, when the systemic symptoms of high fever, anorexia, general weakness and malaise, and subcutaneous nodules developed. The nodules were multiple, red and noted bilaterally on the pretibial areas. Histological findings of his skin lesions showed diffuse cellular infiltrates intermingled with leukemic cells predominantly involving the adipose tissues. The cells displayed negative stainirig to antibodies CD3 and CD20, but positive staining to LCA. The diagnosis of AML(M4) was made by blood and bone marrow studies. He had a rapid downhill course and was discharged after 2 weeks of admission, with no anti-cancer chemotherapy.
Anorexia ; Antibodies ; Bone Marrow ; Diagnosis ; Drug Therapy ; Erythema* ; Fever ; Humans ; Leukemia* ; Leukemia, Myeloid, Acute ; Male ; Middle Aged ; Skin

BACKGROUND: Herpes recurrences coincide with changes in the immunologic status of the patient, particularly in respect of cell mediated immunity (CMI),, and it has been represented that thymopentin(TP) induces a wide range of immunoregulatory effects. OBJECTIVE: Relapses of herpes simplex seem to depend on the relationship between the cellular immune mechanisms and the virus in its latent phase, therefore immunomodulatory therapy may represent an alternative approach. In this respect, thymopentin may have the potential to become a valuable drug for prophylactic use in patients with recurrent herpes simplex. METHODS: Patients with moderate to severe herpes simplex(a relapse rate of at least 6 times/year) were treated with subcutaneous injection of thymopentin 50mg three times weekly for 6 consecutive weeks. The study consisted of a 6-week therapy and a subsequent 1 year follow-up on average. RESULTS: Fourteen of sixteen patients with herpes simplex improved as demonstrated by a reduction in the relapse rate, shorter duration of episodes and improvement in symptoms such as itching or pain. Four patients did not experience a relapse for more than 1 year after cessation of therapy. In this study, the duration of the symptom-free period increased and the average number of relapses per year was reduced. CONCLUSION: Thymopentin is a highly effective drug, capable of positively influencing recurrent herpetic episodes and reducing the relapse rate.
Follow-Up Studies ; Herpes Simplex* ; Humans ; Immunity, Cellular ; Immunomodulation ; Injections, Subcutaneous ; Pruritus ; Recurrence ; Simplexvirus* ; Thymopentin*

We experinced a case of 4p+ syndrome in male infant. He had multiple anomalies such as flat occiput, hypertelorism, low set malformed ear, lower anterior hair line, depressed nose, broad nasal bridge, bilateral complete cleft lip and palate, short neck, unusual position of fingers, ventricular septal defect and umblical hernia. He menifested growth and developmental retardation. Karyotype with banding revealed an extra short arm of chromosome 4. The mother's karyotype was normal. His father and father's sister had a translocation between the short arm of chromosome 4 and the short arm of chromosome 9; their karyotypes were 46, XY, t(4;9) and 46, XX, t(4;9), respectively. In this case, trisomy 4p was the result of parental balanced translocatiom. As this is the first case in Korea, it is worthwhile to report with reviewing literature.
Arm ; Chromosomes, Human, Pair 4 ; Chromosomes, Human, Pair 9 ; Cleft Lip ; Ear ; Fathers ; Fingers ; Growth and Development ; Hair ; Heart Septal Defects, Ventricular ; Hernia ; Humans ; Hypertelorism ; Infant ; Karyotype ; Korea ; Male ; Neck ; Nose ; Palate ; Parents ; Siblings ; Trisomy

PURPOSE: To report a case of deterioration of a retinal arterial macroaneurysm after panretinal photocoagulation (PRP) for diabetic retinopathy. CASE SUMMARY: A 70-year-old woman visited our clinic for evaluation of diabetic retinopathy. Fundus examination and fluorescein angiography showed severe non-proliferative diabetic retinopathy and PRP was planned for the patient. In addition, the patient was found to have a retinal arterial macroaneurysm on the superotemporal area of the retina on her right eye. However, the lesion was small and was located far from the macula, causing no symptoms; thus we decided to observe the patient over a period of time. Two months after PRP, the patient revisited the clinic complaining of acute visual loss. Fundus examination showed vitreous and retinal hemorrhage and optical coherence tomography revealed subretinal fluid in the corresponding area. This was considered to be due to aggravation of the pre-existing macroaneurysm. Intravitreal Bevacizumab injection, C₃F₈ gas injection, and pars plana vitrectomy were performed. After absorption of the hemorrhage, barrier photocoagulation was performed around the retinal macroanerysm. The visual acuity improved and the retina remained stable through the most recent follow-up. CONCLUSIONS: We experienced the rupture of a preexisting retinal arterial macroaneurysm in an asymptomatic patient after panretinal photocoagulation. PRP in diabetic patients could aggravate retinal arterial macroaneurysms. Therefore, it is necessary to carefully examine the patient for retinal macroaneurysms when planning a PRP for diabetic retinopathy.
Absorption ; Aged ; Bevacizumab ; Diabetic Retinopathy* ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Hemorrhage ; Humans ; Light Coagulation* ; Retina ; Retinal Hemorrhage ; Retinaldehyde* ; Rupture ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage