No abstract available.
Lung Neoplasms* ; Lung*

No abstract available.
Hepatitis B* ; Hepatitis*

Immunologic or immunopathologic assays are neccesary for the diagnosis of autoimmune bullous dermatoses including pemphigus vulgaris (PV), bullous pemphigoid (BP), and epidermolysis bullosa acquisita (EBA). The objectives of this study is to compare the sensitivity and usefulness of indirect immunofluorescence 0F) with that of immunoblot assay using amplified alkaline phosphatase staining system in the diagnosis of the above diseases; detection of disease-specific IgG autoantibodies. We selected 4 patients in each bullous dermatosis of PV, BP, and EBA, who had serum levels of IgG autoantibodies at a titer of 1:80 or higher. In each three disease, 2 patients with negative serum antibodies or serum titer lower than 1:20, were also enrolled. Among the former 4-patient groups the titers of IgG antibodies found on indirect IF were in the range of 1:80 to 1:160, whereas the titers recognized by immunoblot assay were 1 or 2 dilutions higher in most of these patients. In the latter 2-patient groups, 4 out of the 6 cases revealed antibody-positive on immunoblot-staining membrane. The indirect IF can be performed easily and seems favorable in the aspect of cost-effectiveness. However, immunoblot assay with sensitive staining method would be warranted in cases of antibody-negative or atypical clinical variants of autoimmunebullous dermatoses to confirm the diagnosis.
Alkaline Phosphatase ; Antibodies ; Autoantibodies ; Diagnosis ; Epidermolysis Bullosa Acquisita ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin G ; Membranes ; Pemphigoid, Bullous ; Pemphigus ; Skin Diseases ; Skin Diseases, Vesiculobullous*

Due to the limited availability of immunoelectron microscopy, an alternative method for the differentiation between anti-lamina lucida and anti-sublamina densa antibodies was introduced; indirect immunofluorescence using NaCl-treated human skin as the substrate. In this study author examined sera and lesional skin of 4 cases of bullous pemphigoid (BP), and 2 cases of epidermolysis bulloaa acquisita(EBA) with the above mentioned indirect imrnunofluorescence and modified direct immunofluorescence to evaluate the specificity of the tests. The results showed that in BP the fluorescence patterns were epidermal in 3 patients with 1 combined by indirect immunofluorescence, and epidermal in all 4 patients by modified direct immunofluorescence. In ERA the fluorescence were dermal patterns in both 2 patients by indirect and modified direct immunofluorescence. These data are further confirming the syecificity and the reproducibility of the NaCl extraction technique for the irnmunofluorescence to differentiate the localization of the autoantibodies in the above two bullous dermatoses.
Antibodies ; Autoantibodies ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescence ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Microscopy, Immunoelectron ; Pemphigoid, Bullous* ; Sensitivity and Specificity ; Skin ; Skin Diseases, Vesiculobullous

No abstract available.
Hepatitis B, Chronic* ; Hepatitis, Chronic*

BACKGROUND: The diagnosis of intraabdominal solid organ injuries is easy for accuracy of the imaging studies, but that of hollow viscus perforations is sometimes relatively difficult. And some of gastrointestinal perforations can be missed and their diagnosis may be delayed. This can result in high morbidity and mortality. So, I studied the incidence and causes of each gastrointestinal tract perforation. METHOD: Four hundred eighty four patients were reviewed, who visited the Emergency Center of Seoul Red Cross Hospital for their gastrointestinal perforations from January, 1987 to December, 1998. Medical records were reviewed in a retrospective manner. The incidence and causes of each hollow viscus perforation, the preferability of each perforation from the pattern of trauma, age and sex distribution in each perforation and associated injuries with trauma were analyzed. RESULTS: The most common perforations were in duodenum(254cases, 52.4%) due to mainly peptic ulcer. The incidence was in order of small bowel(32.6%), stomach(7.4%), colorectum(6.6%) and esophagus(0.8%) after that. Trauma induced perforations were 164 cases(33.9%) and the ratio between blunt and penetrating trauma was 3.9 : 1. Small bowel was most vulnerable site of perforation from both trauma. Duodenum and esophagus were relatively stable from trauma. There were no cases from blunt trauma in stomach and esophagus. The male to female ratio was 5.1 : 1. CONCLUSION: Each hollow viscus has each preferred cause of perforation. It's diagnosis was not easy everytime, sometimes it was really difficult. But pattern of causes in perforations will be helpful to decision making process. In difficult cases, suspicion is very important. And in suspicious perforation of hollow viscus, diagnosis and the decision to operate will be made by frequent physical examination and proper investigating tests.
Decision Making ; Diagnosis ; Duodenum ; Emergencies ; Esophagus ; Female ; Gastrointestinal Tract* ; Humans ; Incidence* ; Male ; Medical Records ; Mortality ; Peptic Ulcer ; Physical Examination ; Red Cross ; Retrospective Studies ; Seoul ; Sex Distribution ; Stomach

Epidermolysis bullosa acquisita (EBA) is an autoimmune blistering disease of the skin occurring mostly in middle-aged persons with characteristic skin lesions of inflammatory in a vesiculobullae and mechanobullous lesions. Separation of the skin occurs at the dermoepidermal junction (DEJ) initiated by an immune process involving the anchoring fibrils (AF) 764, which have a role in the normal adherence of the epidermis and the dermis. Patients with EBA have autoantibodies of IgG to type VII collagen which is the main component of AF. An electron microscopic. picture of normal DEJ is shown in figure 1, and the antigen site 2011s of this disease (AF) is noted at the upper-most part of the dermis. In EBA, a biopsy specimen shows subepidermal bulla with a variable degree of dermal in-filtrates. Immunofluorescence (IF) demonstrates a linear deposit of IgG. The pattern of immune deposits along the DEJ is similar to that of bullous pemphigoid. However, the linear iing. fashion is thicker and coarser. When examined by the indirect method with a semi-horizontal section of normal human skin substrates the same patterns can be observed: a fine linear deposit with bullous pemphigoid antibodies and a slightly coarser linear pattern with EBA antibodies. With salt-split skin substrates, the serum autoantibodies of IgG are found to be bound only to the dermal side, the AF zone (Fig. 2). This immunopathologic study can provide a diagnostic finding. Transmission electron microscopic examination reveals blister to be localized just beneath the lamina densa, the site of the immune deposit. In immunoblot analysis of the patient's serum against the. dermal extracts, serum antibodies are found to recognize type VII collagen of 290/145 kD (Fig. 3). This is a confirmatory technique (with antibody-positive sera) in the diagnosis of EBA.
Antibodies ; Autoantibodies ; Biopsy ; Blister ; Collagen Type VII ; Dermis ; Diagnosis ; Epidermis ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Methods ; Pemphigoid, Bullous ; Skin

Skin lesions of erythema nodosum leprosum(ENL) occurs as crops of erythematous papules with microscopical features of vasculitis, and these are considered to he immune complex mediated. Recent studies by several investigators detected high levels of circulating immune complexes in over fifty percent of patients with ENL, using well known Clq binding assay or monoclonal rheumatoid factor assay. Moreover they found immuoglobulins (Ig) and complement components in the blood vessels of these patients. These immunopathologic data presented more support to the immune complex mediated pathogenesis of the skin lesions in ENL spectrum. In connection with these findings, examinations of the skin lesions of Korean patient with ENL by immunofluorescent techniques were done. Among seven biopsy specimens from each seven patients, four revealed deposits of Igs (G and M) along with CR in dermal blood vesseIs. Alpha-1 antitrypsin and fibrin were also found in some patients.
Antigen-Antibody Complex ; Biopsy ; Blood Vessels ; Complement System Proteins ; Erythema Nodosum* ; Erythema* ; Fibrin ; Humans ; Research Personnel ; Rheumatoid Factor ; Skin ; Vasculitis

Ten serum samples from the patient with bullous pemphigoid with the baseruent mernbrane zone autoantibody titers of 320 or greater were tested, by the method of in vitro complement immunofluorescence, for their ability to fix Factor B and properdin in addition to Clq, C4 and C3. Five samples yielded positive C3 and properdin staining reaciions while four samples demonstrated positive Factor B stainings. All ten samples yieled positive C3, C4 and Clq staining reactions, Heat inactivation or treatment of the complement source with EDTA, MG2-EGTA abolished both C3, properdin and Factor B staining in all ten cases. This result suggest that pemphigoid antibody will fix properdin and Factor B in addition to Clq, C4 and C3, a phenomenon explained by assembly of the C3b amplification mechanism following activation of the classical pathway of complement system.
Complement Factor B* ; Complement System Proteins ; Edetic Acid ; Fluorescent Antibody Technique ; Hot Temperature ; Humans ; Pemphigoid, Bullous* ; Properdin*

The nuclear protein p53 is a tumor suppressor gene product that functions in pathways of cell cycle control and in the repair of damaged DNA. The MDM2 gene codes for a cellular protein that can complex the p53 gene product and negatively regulate its function. Interestingly an autoregulatory feedback loop is set up to regulate the activity of p53 protein and MDM2 gene expression. To evaluate the role of p53 and MDM2 proteins in thyroid carcinogenesis, the author tried immunohistochemical studies in the paraffin embedded sections of 58 thyroid carcinoma cases, including 30 papillary carcinomas, 20 follicular carcinomas, and 8 undifferentiated carcinomas. p53 protein expression was found in 8 cases (26.7%) of papillary carcinomas. It was found in all the cases of undifferentiated carcinomas and not found in the follicular carcinomas. The staining intensity and the frequency scores were more prominent in undifferentiated carcinomas. MDM2 protein expression was found in only 6 cases of papillary carcinomas. It was not expressed in follicular carcinomas or undifferentiated carcinomas. The staining intensity is less than moderate and the frequency score was usually focal. In papillary carcinomas, the correlation of p53 and MDM2 expression was insignificant. In conclusion, p53 may play a major role in tumorigenesis or the progression of undifferentiated carcinomas, but not in the other carcinomas. As compared with papillary carcinomas, follicular carcinomas are regarded as taking a different carcinogenetic pathway. The overexpression of p53 and MDM2 proteins in papillary carcinomas is presumed not to be necessarily correlated with the p53-MDM2 complex formation.
Carcinogenesis ; Carcinoma ; Carcinoma, Papillary ; Cell Cycle Checkpoints ; DNA ; Gene Expression ; Genes, p53 ; Genes, Tumor Suppressor ; Nuclear Proteins ; Paraffin ; Proto-Oncogene Proteins c-mdm2* ; Thyroid Gland* ; Thyroid Neoplasms*