Thelper (Th) cells play a pivotal role in the regulation of immune responses. Since Th epitopes in adenovirus have not yet been defined, in this study, it was attempted to search for Th epitopes of adenovirus antigens that are restricted by MHC class II (H-2E). Among candidate viral proteins to be screened for Th epitopes, structural protein was selected, since they induced strong IL-2 release from adenovirus immune lyrnph node (LN) cells and the presence of E1 protein, which contains immunodominant cytotoxic T lymphocyte epitopes, did not potentiate the T cell responses. To confirm the presence of Th epitopes in the structural protein, virions were trypsinized and the resulting polypeptides whose molecular weights were lower than 5,000 were fractionated by HPLC. Some of the HPLC fraction turned out to induce LN cell proliferation. Ten synthetic peptides were designed as candidate Th epitopes from the primary amino acid sequences of adenovirus hexon and penton protein which are major constituents of the virion. The selected sequences share the common features of other known H-2E' binding ligands. Among these ten synthetic peptides, peptide of hexon protein amino acid residue 709-721 induced noticeable proliferation of LN cells from preimmune mice, and also able to induce IL-2 secretion from adenovirus-specific T hybridomas, suggesting that the peptide was the most immunodominant Th epitope. Hexon protein 221-233 and hexon protein 676-688 are considered as epitopes also. This study revealed three epitope sequences from adenovirus structural protein that are presented by class II MHC, H-2E.
Adenoviridae* ; Amino Acid Sequence ; Animals ; Cell Proliferation ; Chromatography, High Pressure Liquid ; Epitopes ; Epitopes, T-Lymphocyte* ; Hybridomas ; Interleukin-2 ; Ligands ; Mice ; Molecular Weight ; Peptides ; Trypsin ; Viral Proteins ; Virion

We studied the left ventricular function with the use of M-mode and 2-D Echocardiography to 32 patients with congestive heart failure before and 2 weeks after medication of prazosin 2 mg tid during July 1979 and Dec. 1980 in Heart Center, Paik Hospital, In-Je Medical College, Busan, Korea. The results were following; 1) LVDeD before and after vasodilaor therapy was each 5.64+/-0.76 and 5.04+/-0.57.cm, LVSeD before and after therapy each 4.52+/-0.51 and 3.70+/-0.57cm, and F.S. before and after therapy 19.87+/-3.66 and 26.59+/-6.75%. The difference of LVSeD, LVDeD and F.S. was each statistically significant. 2) LVDeV before and after therapy was each 182.2+/-58.07 and 132.80+/-47.01 ml LVSeV before and after therapy each 92.35+/-23.60 and 50.65+/-27.21ml, and E.F. before and after therapy each 49.31+/-7.07 and 61.86+/-11.74%. The difference of LVDeV, LVSeV and E.F. was each statisitically significant. 3) LVPWTh before and after therapy was each 0.89+/-0.11 and 0.77+/-0.08cm, and Vcf before and after therapy 0.83+/-0.11 and 1.03+/-0.27 cir./sec. The difference of LVPWTh and vcf before and after therapy was each statistically significant. 4) The difference of VSTh, RVD, LAD, and Aorta Dimension before and after therapy was each statisitically significant.
Aorta ; Busan ; Echocardiography* ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Heart Ventricles* ; Humans ; Korea ; Prazosin ; Ventricular Function, Left

There are few reports in the literature on how to care and manage bi!ateral congenital dislocation of the hip. Six patients have been encountered at this hospital from June 1979, of them four children had operative treat ment and the other two conservative. As a result of our experience about the management of bilateral congenital dislocation of the hip. The authors obtained the following conceptions; 1. The patient with bilateral dislocation was rather delayed in diagnosis. Therefore, in comp the treatment of bilateral cases was poorer than that of unilateral case. 2. In the case of the dislocated hip that might be easily reduced and maintained in the stab servative care was usually recommeded even in the older child. Unstable, unreduced hip,; hip in old children, the more definitive operation and internal & external rigid immobilization mandatory to get good result. 3. It might be beneficial to operate the more deformed and resistive hip first, and then to p with the same procedure 2 weeks after the first operation.
Child ; Diagnosis ; Dislocations ; Fertilization ; Hip ; Humans ; Immobilization

No abstract available.
Leukemia, Neutrophilic, Chronic*

Histiocytosis-X has several mode of presentation, from the mildest solitary eosinophilic granuloma of bone to the most severe, with multiple granulomata in bones and soft tissues. This disease previously described as eosinophilic granuloma, Hand-Schuller-Christian disease and Letterer-Siwe disease. Lichtenstein (1953) used the term histiocytosis-x to encompass the above three names. We experienced a case of histiocytosis-x which had occured at multiple site of bones. The patient has good general condition with complete subsidance of specific symtoms and signs in our thirty-eight months follow up treatment.
Eosinophilic Granuloma ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans

The “delta phalanx”, first named by BlundeII Jones in 1964, is a triangular(“delta-shaped”) or trapezoidal phalanx with C-shaped epiphyseal plate causing progressive angular deformity of the digit with growth. Neither splinting nor physical therapy is effective in improving the condition. Surgical correction is indicated and several methods of correction have been reported. Authors have experienced a rare case of “delta phalanx” occuring in the proximal phalanx of the syndactylous digit.
Congenital Abnormalities ; Growth Plate ; Splints ; Syndactyly

Fourty one cases of open fractures of tibial shaft complicated with varying degrees of soft tissue injuries were trested by one-plane unilateral external fixation with AO fixator. In seventeen csses among them, interfragmental lag screw fixation was applied in addition, for more rigidity and stability of the fixation. All of thern were followed up at least for one year and we obtained the following results. 1. Rigid stable external fixation provided by additional minimum internal fixation may not increase the rate of infection but rather enhance prompt primary bone healing. 2. One-plane unilatersl external fixation may facilitate good access to the wound for subsepuent reconstructive procedures, and enhance pain-free early full range of joint motion, thus promote early bone union. 3. Comparing with bilsteral fixation, there wss almost no difference in the union time of the fracture even with one-plsne unilatersl fixation.
Clinical Study ; External Fixators ; Fractures, Open ; Joints ; Soft Tissue Injuries ; Tibia ; Wounds and Injuries

From September 1992 to April 1994, we reviewed 7 patients after arthroscopic surgery for anterior impingement in the ankle, who complained ankle pain and limitation of motion. All patients were mem and main symptoms were severe pain at full dorsiflexion of ankle and limitation of motion. Bony spur was located on the anterior aspect of tibia, and it was possible to resect the tibial bony spur arthroscopically without distraction devices. Mean operation time was 55 minutes. Pain, swelling and limitation of motion were much improved. There was no postoperative complication. Arthroscopic resection of the anterior tibial bony spur is an effective treatment for anterior impingement in the ankle.
Ankle ; Arthroscopy ; Humans ; Postoperative Complications ; Tibia

We retrospectively evaluated datas on 61 cases of neonatal sepsis confirmed by clinical symptoms and blood cultures at the NICU of Gil general hospital From Mar. 1989, to Fed. 1992. The results obtained were as follows: 1) The mean gestational age was 32.7+/-2.6 Weeks in preterm infants, and 39+/-1.5 weels on term infants. The mean birth weight was 1,701.4+/-422.4 g in preterm infants, and 3,232+/-581.7 g in term infants. 2) There were 61 infants with neonatal sepsis identified among 13, 486 live births, resulting in an incidence of 0.45%. The sex ratio of male to female was 1.2:1. The incidencdence was higher in preterm infants (2.21%) than in term infants (0.27%). 3) The most commom presenting symptoms of neonatal sepsis were apnea and bradycardia (53.6%) in preterm infants, jaundice (33.3%) in term infants 4) The concurrent diseases in neonatal sepsis were urinary tract infection (UT)(25%), pneumonia (21%), hyaline membrane disease (21%) in the order of frequency. Hyaline membrane disease (33.3%) was the most frequently associated disease in preterm infants, UTI (41.4%) in term infants 5) Gram positive organisms were isolated in 33 casess (52%), gram negative organisms in 30 cases (48%). The most common ortanism isolated from blood cultures was CONS (28.6%). The more common organisms in preterm infants were CONS (26.7%), Enterococcus (23.3%) and Klebsiella (10%). CONS (30.3%), E. Coli (27.3%) and Staphylococcus aureus (12%) were more frequent in term infants. 6) The significant diagnostic laboratory findings for neonatal sepsis were leukopenia ( < or =5000), I:T 0.16, thrombocytopenia ( <150,000/mm3), CRP> or =1+.2 or more of abnormal hematologic values were significantly more frequent in preterm infants (P< 0.05). 7) The risk factors associated with neonatal sepsis were endotracheal intubation (57%), birth ashyxia (Apgar score< or =6 at 5 min.)(39%) and umbilical catheterization (35.7%) in preterm infants, while endotrachial intubation (12.1%), birth ashyxia (12.1%) and premature rupture of membrane ( > or =24hrs)(9.0%) in term infants. 8) Early onset neonatal sepsis (72< or =hr of age) was found in 40 cases (65.6%). 9) The overall mortality rate of neonatal sepsis was 26.0%(39,3% in preterm infants, 15.2% in term infants). The mortality rate was significantly high in pseudomonas infection. 10) In low birth weight infants, the susceptibility to neonatal sepsis was greatest in the infants of lowest birth weight (1,00-1,500 gm) and the mortality rate was inversely proportional to birth weight. 11) Sensitivity to antibiotics in gram postitive organisms were chlorampjenicol (37%), Erythromycin (29%), ampicillin (26%) and cephalothin (26%). It clearly showed that newer antibiotics such as vancomycin is neccessary. In cases of gram negative organisms, sensitivity to antibiotics were amikacin (85%), gentamicin (65%), tobramycin (58%) and cephalothin (54%).
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Apnea ; Birth Weight ; Bradycardia ; Catheterization ; Catheters ; Cephalothin ; Enterococcus ; Erythromycin ; Female ; Gentamicins ; Gestational Age ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Intubation ; Intubation, Intratracheal ; Jaundice ; Klebsiella ; Leukopenia ; Live Birth ; Male ; Membranes ; Mortality ; Parturition ; Pneumonia ; Pseudomonas Infections ; Retrospective Studies ; Risk Factors ; Rupture ; Sepsis* ; Sex Ratio ; Staphylococcus aureus ; Thrombocytopenia ; Tobramycin ; Urinary Tract Infections ; Vancomycin

Newborn premature babies have lwo levels of transplacentally acquired maternal immunoglobulin which is mostly transferred after 32~34 weeks gestaton, therefore they may have IgG deficiencies that increase their susceptibility to bacterial infection. We performed this study to determine whether intravenous immunoglobulin (IVIG) therapy improves mortality or infection occurrance rate. From 1 october 1991 to 31 July 1992, 73premature newborn infants with gestational age< or =34weeks were enrolled: the theatment group, consisting of 43infants who received prophylactic intravenous immunoglobulin therapy (500mg/kg/week) and the control group, consisting of 30infants who did not receive. prophylactic intravenous administration of immunoglobulin to preterm infants with a gestational ageage< or =34week, at a dose of 500mg/kg/week, results in maintenance of a satisfactory serum IgG level throughout the high-risk period for infection. But the incidence rates of proven or very probable sepsis, mortality for sepsis and total mortality in the infants receiving intravenous immunoglobulin were not significant differences when compared with those in the control infants. No adverse effects were noted after immunoglobulin transfusions in our subjects. In conclusion, our study does not show any decrease in bacterial infection rate or in mortality rate, and no study in the literature has shown absolute proof of the prophylactic efficacy of IVIG in premature newborns. Larger studies are necessary to confirm these observations and to determine more effective dosing schedules and the optimal levels of orhanism-spectific antibodies. And specific hyperimmnue of monoclonal antibody preparations may be required to provide reliable sources of effective prophylactic to premature neonate with high risk in bacterial sepsis.
Administration, Intravenous ; Antibodies ; Appointments and Schedules ; Bacterial Infections ; Humans ; IgG Deficiency ; Immunization, Passive ; Immunoglobulin G ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Mortality ; Sepsis*