The cytolytic activity of CD4' T cells, both human and murine, has been clearly demonstrated in the immune response to mycobacterial infection and suggested to play a significant role in the protection and immunopathology. However, Uttle is known about the differentiation of CD4' CTL. In order to address this issue, we examined the influences of some factors on the generation of CD4' CTL specific to mycobacterial antigens. After 7 days' stimulation of PBMCs from healthy tuberculin reactors with mycobacterial antigens, the cytolytic activity of purised CD4' T cells toward autologous macrophages infected with mycobacteria was measured by Cr release assay. First, we found that both of live M. tubeiculosis and soluble antigens (ST-CF) induced the cytolytic activity of CD4' T cells, although the inducibility of the former was slightly greater than the latter. Second, the cytolytic activity was maximally induced at the relatively low antigen concentration (0.2:1 bacteria:monocyte ratio or 0.5 mg/ml of ST-CF). Finally, in the presence of increasing amounts of neutralizing anti-IL-12 or anti-IFN-r MoAb, the cytolytic activity of CD4+ T cells was decreased in a dose-dependent manner. These results suggest that low dose of antigen, its particulate type give mycobacteria), IL-12, and IFN-r give some positive signals for the generation of CD4+ CTL.
Humans ; Interleukin-12 ; Macrophages ; T-Lymphocytes* ; Tuberculin

Three combinations of cloths were evaluated for the protective effects of different kinds of clothings in cold environments. Table 1 shows tile components of tile three models of clothings. A prototype was made by putting a sheet of vinyl at the middle layer of raw cotton in a fabric-quilt cloths. A glove mannequin was covered by each of these cloths. The globes contained 1,000 cc of hot water about 40 degrees C. Tele-thermisters were fixed in order to check the temperature of cloths space and water temperature for evaluation of caloric-loss and climate of clothings. Results are summarized as follows : 1) Without wind, there is no significant difference of air temperatures between ski-parka and quilt wear clothing. 2) The prototype with vinyl sheet best protects against wind, the next is the ski-parka. Quilt-wear protects the least. 3) It is well-known that a working-clothing needs not have any separate liners nor outers. 4) For innermost layer of a clothing preventing cold, a cotton-fabrics is recommended and a water-proof cloths for outer layer. 5) Heat-loss was calculated from the cooling degrees of water. Calorie-loss was 910ca1/m2/hr. when bared, but with the prototype of vinyl sheets the calorie-loss was 350cal/m2/hr. (38.5% of bared). Quilt-wear and ski-parka were 380(41.8%) and 440 cal/m2/hr. (48.4%) respectively.
Climate ; Clothing* ; Manikins ; Water ; Wind*

Fournier's gangrene is an infective necrotizing fasciitis of the perineal, genital or perianal regions. Management of this disease has involved prompt surgical debridement with initiation of broad spectrum antibiotics and intensive supportive care. Multiple debridements orchiectomy, urinary deversion, and fecal diversion should be performed as clinically indicated. Hyperbaric oxygen therapy and topical application of unprocessed honey may prove to be useful adjuncts as new therapies. After excision of all necrotic tissue, the tissue losses have been managed by primary repair. split-thickness skin grafts, rotational or free myocutaneous flaps and omental flaps. Skin graft did not take on bare testis lacking the tunica vaginalis, and gracilis myocutanous flap was too bulky to cover the scrotal area. The progress of necrosis ceased by using intravenous PGE1 injection in the aspect of characteristic obliterative endarteritis causing cutaneous and subcutaneous vascular thrombosis and necrosis of tissue in Fournier's gangrene. We have reconstructed large scrotal defects with bilateral superomedial thigh flap in three Fournier's gangrene patients after stopping tissue necrosis with PEG1 treatment and several surgical debridements of the wounds. The use of this flap ensures a virtually normal sensation, which is important for the erotic propensity of the scrotum. Easy flap design and dissection, as well as primary closure of the donor site, are another benefits of this method.
Alprostadil* ; Anti-Bacterial Agents ; Debridement ; Endarteritis ; Fasciitis, Necrotizing ; Fournier Gangrene* ; Honey ; Humans ; Hyperbaric Oxygenation ; Myocutaneous Flap ; Necrosis ; Orchiectomy ; Scrotum ; Sensation ; Skin ; Testis ; Thigh* ; Thrombosis ; Tissue Donors ; Transplants ; Wounds and Injuries

This retrospective study evaluated possible rupture of silicone gel breast implants in 92 patients. the series included patients undergone augmentation mammoplasty(n=59), and reconstructive mammoplasty(n=23) from Sep. 1993 to Aug. 1996. the age of implants ranged from 4 months to 8 years(mean:23.1months). of these, 19 cases displayed Ultrasonographic sings of rupture. of 13 implants removed, 7 were intact and 6 were ruptured. Implant contour deformities and radial folds are often seen in both ruptured and intact silicone implants and therefore cannot serve as reliable signs of rupture. A stepladder sign in intact implant is believed to be the result of reverberation artifacts within the interior of the implant. Due to these false-positive ultrasonographic findings, ultrasonographiy is not as absolutely reliable tool for the diagnosis of implant rupture. Alternative imaging methods(CT, MRI) are required to establish an accurate preoperative diagnosis.
Artifacts ; Breast Implants* ; Breast* ; Congenital Abnormalities ; Diagnosis ; Humans ; Retrospective Studies ; Rupture* ; Silicone Gels*

STUDY DESIGN: An experimental study. OBJECTIVES: To define the phases of chronic spinal cord injury by researching the changes in gene expression. SUMMARY OF LITERATURE REVIEW: The exact time of conversion from acute stage to chronic stage in spinal cord injury is unknown. MATERIALS AND METHODS: We used 18 month-old Beagle dogs as study subjects. Under spinal cord monitoring, we underwent laminectomy on thoracic vertebra 10 and 11, and induced cord injury by a weight-drop injury method. Dogs in each group with spinal cord injury and group without spinal cord injury on POD 1, 7, 30, and 90. The motor functions were evaluated using the Tarlov scale. Tissues were prepared from 0.5cm up and down from the 10th thoracic level. Additional cephalic and caudal lesions from the injured site were prepared. We have checked the differentially expressed gene(DEG). RESULTS: The mean Tarlov value was 0.67 which indicated a significant cord injury. 4 DEG (GP3, 9, 25, 34) were detected among 40 primers after screening, the detection percentage of which was 10. In the tissues of study subjects with spinal injury, DEG was found at the injury site and cephalic lesion. DEG expressed GP3, GP9 and GP34 started expression on day 30, and GP25 was expressed on day 90. CONCLUSIONS: According to the changes in gene expression, the day 30 would be considered as the date of conversion from acute to chronic phase of cord injury. Inhibiting secondary inflammatory change and apoptosis following spinal cord injury until this period would maximize the effect of chronic phase therapy such as cell-transplantation.
Animals ; Apoptosis ; Dogs ; Gene Expression ; Laminectomy ; Mass Screening ; Spinal Cord ; Spinal Cord Injuries ; Spinal Injuries ; Spine

PURPOSE: The purpose of this study is to evaluate the usefulness of computed tomography (CT) for spiral tibia shaft fracture by analyzing associated distal tibia intra-articular fractures diagnosed by CT only which met the indication of surgical fixation and were fixed. MATERIALS AND METHODS: Ninety-five spiral tibia shaft fractures with preoperative ankle plain radiographs and CT were analyzed retrospectively. The incidence and type of associated distal tibia articular fractures were evaluated by reviewing ankle plain radiography and CT. The number of fractures diagnosed by CT that correspond with the indication of fixation and that were actually fixed were analyzed. RESULTS: Among 95 spiral tibia shaft fractures, 62 cases (65.3%) were associated with distal tibia intra-articular fracture. There were 37 cases of posterior malleolar fracture, 5 cases of avulsion fracture of the distal anterior tibiofibular ligament, 5 cases of medial malleolar fracture, and 15 cases of complex fracture. Among 52 posterior malleolar fractures including complex fracture, 20 cases were diagnosed by ankle plain radiograph. Of these 20 cases, 16 posterior malleolar fractures (80.0%) met the indication of surgical fixation, and 14 cases were actually fixed with a screw. Among 32 posterior malleolar fractures diagnosed by CT only, 26 cases (81.3%) met the indication of surgical fixation and 18 cases (56.3%) were fixed by screw. CONCLUSION: Approximately 50% of associated fractures were diagnosed by CT only and more than 80% of associated posterior malleolar fractures met the indication of surgical fixation and among these fractures, 18 cases (56.3%) were actually fixed by screw. This result suggests that CT is useful in diagnosis and treatment of distal tibia intra-articular fracture associated with spiral tibia shaft fracture.
Ankle ; Ankle Fractures ; Diagnosis ; Incidence ; Intra-Articular Fractures* ; Ligaments ; Radiography ; Retrospective Studies ; Tibia*

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of atypical spinal tuberculosis. SUMMARY OF LITERATURE REVIEW: In spinal tuberculosis, non-contiguous multifocal involvement and isolated involvement of posterior elements of the spine have been considered atypical features. There have been a few reports of each of these atypical features but no reports have described spinal tuberculosis with both of these atypical features. MATERIALS AND METHODS: A 39-year-old man presented with back pain and progressive weakness of both lower extremities. He was diagnosed with spinal tuberculosis from the cervical to sacral spine, showing multifocal non-contiguous involvement with multiple abscesses on magnetic resonance imaging. Notably, in the thoracic spine area, isolated involvement of posterior elements was found with an epidural abscess compressing the spinal cord. He underwent a total laminectomy of the thoracic spine and multiple abscesses were drained with pigtail catheter insertions into the cervical, thoracic, and lumbar spine. RESULTS: At the 8-month follow-up, the patient's neurologic status had improved to Frankel Grade D, and the patient was able to walk with the support of a walker. At the 3-year follow-up, the patient had recovered completely without any neurologic deficit. CONCLUSIONS: Since atypical spinal tuberculosis may show various patterns, examination of the entire spine is important for early diagnosis. Treatment should be provided properly from minimally invasive procedures to open surgery depending on the extent of structural instability and neurologic deficit.
Abscess ; Adult ; Back Pain ; Catheters ; Decompression ; Early Diagnosis ; Epidural Abscess ; Follow-Up Studies ; Humans ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Spinal Cord ; Spine ; Tuberculosis, Spinal* ; Walkers

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of extensive epidermoid cysts in the lumbosacral spine. SUMMARY OF LITERATURE REVIEW: The intradural epidermoid cyst with extensive involvement is rare, and previous reports have reported only extensive intramedullary epidermoid cysts. MATERIALS AND METHODS: A 75-year-old male presented with progressive motor weakness of both extremities beginning 3 days prior. MRI showed extensive intradural extramedullary epidermoid cysts in the lumbosacral region. We performed total laminectomy from the L1 to the L5 level, and the cystic mass was removed. RESULTS: We confirmed the epidermoid cyst on histopathologic examination. CONCLUSIONS: Extensive extramedullary epidermoid cysts are difficult to remove completely. Attempting complete removal may result in neurological deficit. Therefore, when surgical intervention is planned, the poor postoperative prognosis should be taken into consideration.
Aged ; Cauda Equina* ; Epidermal Cyst* ; Extremities ; Humans ; Laminectomy ; Lumbosacral Region ; Magnetic Resonance Imaging ; Male ; Polyradiculopathy* ; Prognosis ; Spine*

No abstract available.
Radiography* ; Radionuclide Imaging* ; Sacroiliitis* ; Spondylitis, Ankylosing*

In the summer of 1969 from July through October, authors carried out a study of susceptibility in adult female bed bug(Cimex lectularius) in order to ascertain any development of resistance to insecticides in Korea. The test to DDT and Dieldrin was performed in laboratory by the continuous exposure of residues method, with standard impregnated paper used for adult mosqitoes. Some results so far obtained can be summarised as follows: LC(50) were 2.839% in DDT and 0.167% in Dieldrin. The resistance has been arisen 2.4-2.9 times in DDT and 1.6-2.4 times in Dieldrin as compared with London laboratory strain, but they were susceptible 1.4 times in DDT and 180 times in Dieldrin as compared to Israel resistance strain.
parasitology-arthropodology-bed bug-Cimex lectularius ; prevention ; chemotherapy ; resistance ; DDT ; dieldrin