The immunologic reactivity of a lipopolysaccharide (LPS)-protein complex isolated from a potassium thiocyanate extract of a Pasteurella multocida (capsular type A and somatic type 3) strain was evaluated in mice. The LPS-protein complex provided 100% protection in mice against a challenge with the homologous strain. However, when the complex was fractionated into LPS and protein moieties by phenol-water treatment, both components lacked immunogenicity. The complex and extracted components were mitogenic for mouse B lymphocytes with the protein moiety the most active. Although immune serum against the LPS-protein complex protected mice against challenge thereby indicating a role for humoral immunity, the LPS-protein complex of P. multocida was also found to induce cell-mediated immunity. This cell-mediated immunity was demonstrated in mice immunized with the complex by: (1). mitogenic responses of T lymphocytes, (2). induction of delayed type hypersensitivity reaction in the hind footpads, and (3). enhanced resistance to challenge infection with Salmonella enteritidis.
Animals ; Antibodies, Bacterial/blood/immunology ; Bacterial Proteins/chemistry/*immunology ; Chemical Fractionation ; Hypersensitivity, Delayed ; Immune Sera/immunology ; Immunity, Cellular ; Immunization, Passive ; Lipopolysaccharides/chemistry/*immunology ; Lymphocyte Activation ; Mice ; Pasteurella Infections/immunology/*prevention & control ; Pasteurella multocida/*chemistry/immunology ; Salmonella Infections, Animal/immunology/prevention & control ; Salmonella enteritidis/growth & development/immunology ; Spleen/cytology/immunology/microbiology

PURPOSE: To describe the magnetic resonance (MR) imaging findings of hypertrophic olivary degeneration (HOD). MATERIALS AND METHODS: MR images of seven patients with HOD were retrospectively reviewed. Two were women and five were men, and they were aged between 48 and 65 (mean 58) years. Imaging examinations were performed with a 1.5-T unit, and the findings were used to evaluate the size and signal intensity of olivary lesions. The time interval from hemorrhagic ictus to MR imaging was between two and 30 months. Follow-up examinations were performed in two patients. RESULTS: All four patients with hemorrhages involving the central tegmental tract in the pons or midbrain showed ipsilateral HOD. Among these four, bilateral HOD was seen in one patient with hemorrhage involving the bilateral central tegmental tract, and in another with tegmental hemorrhage extending to the ipsilateral superior cerebellar peduncle. One patient with cerebellar hemorrhage involving the dentate nucleus had contralateral HOD. Two patients with multiple hemorrhages involving both the pons and cerebellum showed bilateral HOD. Axial MR images showed mild enlargement of the involved olivary nucleus, with high signal intensity on both proton density and T2 weighted images. There was no apparent enhancement on postcontrast T1-weighted images. CONCLUSION: MR imaging can clearly distinguish secondary olivary degeneration from underlying pathology involving the central tegmental tract in the pons or midbrain and cerebellum. These olivary abnormalities should not, however, be mistaken for primary medullary lesions.
Cerebellar Nuclei ; Cerebellum ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Male ; Mesencephalon ; Olivary Nucleus ; Pathology ; Pons ; Protons ; Retrospective Studies

PURPOSE: For diagnosis of growth hormone(GH) deficiency in short stature, peak growth hormone levels after pharmacologic stimulation are usually used. In this study, we measured serum IGFBP-3, which is a major binding protein in serum and is considered to be GH-IGF-I axis dependent, levels by radioimmuno assay(RIA) in sera from normal short stature(NSS) children, and patients with GH deficiency children to clarify the utility of IGFBP-3 level as a diagnostic marker for GH deficiency. METHODS: At the department of Pediatrics, Hanyang University Hospital from November, 1992 to July, 1995, we selected 32 GH deficiency-suspected children on the base of their growth data and bone age. After GH stimulation with clonidine(100-150mug/m2) and L-dopa(200-250 mg/m2), we measured their peak GH levels by the immunoradiometric assay(IRMA) kit(Immunodiagnostic system, UK), IGFBP-3 level by radioimmuno assay(RIA) kit(Diagnostic system labortories, USA). RESULTS: 1) The mean IGFBP-3 levels of eight normal short stature(NSS) in Tanner stage I is 2.4+/-1.5mug/ml and their stimulated mean peak GH level is 18.7+/-7.5ng/ml. However, one child in Tanner stage I with nutritional deficiency, IGFBP-3 level is 0.717mug/ml and stimulated peak GH level is 12.2ng/ml. And the mean IGFBP-3 and peak GH levels of two Tanner stage II NSS are 2.2+/-1.2mug/ml and 14.3+/-5.2ng/ml, respectively. 2) The mean IGFBP-3 level of five partial GH deficient(PGHD) children in Tanner stage I is 1.8+/-1.1mug/ml, and their stimulated mean peak GH level is 8.2+/-1.3ng/ml. The mean IGFBP-3 level of five PGHDs in Tanner stage II is 2.2+/-0.8mug/ml, and their stimulated mean peak GH level is 7.5+/-1.5ng/ml. 3) The mean IGFBP-3 level of six complete GH deficient(CGHD) children in Tanner stage I is 0.7+/-0.6mug/ml, and their stimulated peak GH level is 1.0+/-1.2ng/ml. The mean IGFBP-3 level of three complete GH deficient(CGHD) children in Tanner stage II is 2.2+/-0.2mug/ml, and their stimulated peak GH level is 2.5+/-1.4ng/ml. Only one CGHD child in Tanner stageIII, IGFBP-3 level is 5.943mug/ml, and his stimulated peak GH level is 3.3ng/ml. 4) There is no significant difference of mean IGFBP-3 levels between NSS and PGHD in Tanner stage I, but the mean IGFBP-3 level is significant difference between NSS and CGHD in Tanner stage I(p<0.05). 5) The sensitivity of IGFBP-3 for CGHD and PGHD less than 9 years old is 83%, 75% and for all age is 80%, 55%, respectively. The sensitivity of IGFBP-3 for GH deficiency in less than and older than 9 years is 80%, 67%, respectively. The specificity of IGFBP-3 for NSS is 64%. CONCLUSIONS: Because serum IGFBP-3 levels may increased during puberty due to mechanisms independent of the GH-IGF-I axis, it is difficult to distinguish GH deficiency from NSS in older children, but CGHD in Tanner stage I, we may use the basal plasma IGFBP-3 level as a screening test for diagnosing GH deficiency.
Adolescent ; Axis, Cervical Vertebra ; Carrier Proteins ; Child ; Diagnosis ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Protein 3* ; Malnutrition ; Mass Screening ; Pediatrics ; Plasma ; Puberty ; Sensitivity and Specificity

Spinal fixation using pedicle screws has recently been the focus of increased attention, but the adequate size of pedicle screw and maximum percentage fill as related to the pedicle diameter and are not well known. The objects of this study were to determine the ideal ratio among pedicle, drill and screw diameter, and to determine the maximum percentage fill of the screw without significant decrease of pull-out strength. The materials used for the experiments were 376 thoracic pedicles obtained from the 38 young pigs, and the diameters of pedicles ranged from 3.0 to 8.5mm. After 40% to 100% drilling as compared to pedicle diameter, screws were inserted carefully, and measurements were taken of the outer pedicle changes and pull-out strengths, and adequate drill and screw sizes as related to the diameters of given pedicles were determined. It was found that pull-out strength was the strongest after 60% drill, and the larger the drill diameter, the smaller the holding power, and the larger the screw diameter, the greater the holding power. Maximum pull-out strength was seen at 80-90% fill with 60% drill. After sequentially drilling each pedicle with increasingly larger drill bits, larger screws could be inserted with pedicle changes such as expansion, cutout, split fracture, and comminuted fracture. after larger drilling up to 100%, pedicle screws with diameters smaller than 115% of measured pedicle diameters could be safly inserted without fracture and significant decrease of pull-out strength. It is concluded that effective percentages of drill and screw diameters to the pedicle diameter are 60% and 80-90% respectively, and pedicle screw up to 115% of measured pedicle diameter can be safely inserted into pedicle without significant decrease of pull-out strength. It is thought that fresh pedicle has elasticity and larger screw can be inserted to the pedicle with strong holding after larger drilling.
Elasticity ; Fractures, Comminuted ; Pedicle Screws ; Swine

No abstract available.
Korea* ; Scrub Typhus*

Postpneumonectomy syndrome is a disease entity which arises after right pneumonectomy in left aortic arch and left pneumoncectomy in right aortic arch. This syndrome have a feature of severe mediastinal deviation and rotation, and induces severe respiratoy insufficiency. This syndrome is rare, but should be considered when pneumonectomized patient complaints who have severe dyspnea. In Samsung medical center, We report a sucessfully treated patient with postpneumonectomy syndrome, who had experienced right pneumonectomy at 1 years ago.
Aorta, Thoracic ; Dyspnea ; Humans ; Pneumonectomy ; Postoperative Complications

PURPOSE: Cyclin D1, which is known as a cell regulatory protein in G1-S phase, is overexpressed in 30-90% of breast cancers. Published data on the relationships between cyclin D1 and the established clinicopathologic factors of breast cancer have been controversial, so we investigated the clinical significance of cyclin D1 and its associations with established clinicopathologic factors in 103 primary breast-cancer patients. METHODS: Cyclin D1 overexpression was measured by using immunohistochemical assays, and the results were compared with clinicopathologic factors. RESULTS: Expression of cyclin D1 was detected in 60.2% (62/103) and cyclin D1 was significantly correlated with the estrogen receptor, the progesterone receptor, lymph-node metastasis, histologic grade, and nuclear grade. But there were no associations between cyclin D1 and tumor size, tumor stage, vascular invasion of tumor, DNA ploidy and S phase. CONCLUSION: We found that breast cancer with cyclin D1 overexpression was associated with predictive factors such as the estrogen receptor and the progesterone receptor. Thus, we suggest that aggressive treatment is needed in breast cancer with cyclin D1 overexpression. For cyclin D1 to become a more informative clinical prognostic factor, more prospective studies with large sample sizes are needed.
Breast Neoplasms* ; Breast* ; Cyclin D1* ; Cyclins* ; DNA ; Estrogens ; Humans ; Neoplasm Metastasis ; Ploidies ; Receptors, Progesterone ; S Phase ; Sample Size

Five cases of traumatic intracranial aneurysm were presented. All of them were located at the cavernous segment of the internal carotid artery. These lesions were associated with basal skull fracture. Four cases were presented with massive epistaxis, and two of them required transfusion. All cases were treated successfully:four by detachable balloon occlusion of the proximal internal carotid artery and one by trapping of the lesion at the internal carotid artery. Because the mortality rate of ruptured traumatic aneurysm if high, clinical suspicion must be focused on prompt diagnostic work-up and early treatment.
Aneurysm ; Aneurysm, False ; Balloon Occlusion ; Carotid Artery, Internal ; Epistaxis ; Intracranial Aneurysm* ; Mortality ; Skull Fractures

No abstract available.
Placenta Previa* ; Placenta*

OBJECTIVES: Protein-calorie malnutrition has been shown to be prevalent among patients on chronic dialysis, And assessment of nutritional status of continuous ambulatory peritoneal dialysis(CAPD) patients has assumed greater importance because of the association of protein-calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling and cretinine clearance in CAPD patients. METHODS: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 82CAPD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling and creatinine clearance with the other parameters of nutritional status. RESULTS: The malnutrition index classified 47(57%) patients as normal, 30(37%) intermediately malnourished, and 5(6%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle area (MAMA), duration of CAPD, subjective symptoms, serum albumin, transferrin, cholesterol, and triglyceride. The malnutrition index also showed a significant correlation with residual renal function(RRF), and standardized creatinine clearance(SCCr). The TWR-Kt/V(total Kt/Vurea per week with consideration of residual renal urea clearance) was significantly lower in the severely malnourished group than in the normal group. Serum alkaline phosphatase and BUN levels were higher in the severely malnourished group than in the normal and inter-mediate groups. CONCLUSION: In assessing the nutrition status of CAPD patients, body weight, TSF, MAC, MAMA, subjective symptoms, serum albumin, transferrin, cholesterol, triglyceride, urea nitrogen, and alkaline phosphatase were considered useful parameters. There was a trend of increased BUN and decreased TWR-Kt/V in severely malnourished patients, and the value of SCCr was significantly lower in malnourished patients. However, no meaningful relationships between TW-Kt/V and malnutrition index or between NPCR(normalized protein catabolic rate) and malnutrition index were found m this cross-sectional study. As the number of patients with longer duration of CAPD or negligible RRF has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and SCCr, may be helpful to assess dialysis adequacy to keep good nutritional status of each CAPD patient.
Alkaline Phosphatase ; Anthropometry ; Body Weight ; Chemistry ; Cholesterol ; Creatinine* ; Cross-Sectional Studies ; Dialysis ; Humans ; Incidence ; Malnutrition ; Mortality ; Nitrogen ; Nutritional Status ; Peritoneal Dialysis, Continuous Ambulatory* ; Protein-Energy Malnutrition ; Serum Albumin ; Transferrin ; Triglycerides ; Urea*