No abstract available.
Orientia tsutsugamushi* ; Rickettsia* ; Ulsan*

OBJECTIVE: To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis in patients who had failed medical management. METHODS: A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. RESULTS: There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from 3.78+/-0.78 preoperatively to 4.78+/-0.35 at final follow up and mean VAS score was improved from 7.43+/-0.54 to 2.07+/-1.12. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. CONCLUSION: According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.
Anti-Bacterial Agents ; Bone Transplantation ; Coinfection ; Debridement ; Decompression ; Discitis ; Female ; Follow-Up Studies ; Humans ; Liver Diseases ; Male ; Military Personnel ; Mycobacterium tuberculosis ; Spine ; Staphylococcus ; Transplants ; Tuberculosis ; Tuberculosis, Pulmonary

We isolated Triton X-100 solubilized protein (TSP) antigen which may be preferentially associated with the cell wall of M. tuberculosis. In this study, the proliferative activities and cytokine mRNA expression patterns of the TSP antigen were investigated in peripheral blood mononuclear cells (PBMCs) and lymph node mononuclear cells (LNMCs) from 4 patients with tuberculous lymphadenitis. The results of the TSP antigen were compared with those of the PPD antigen, known as a major seretory protein antigen of M. tuberculosis. The peak proliferative response to the TSP by PBMCs was observed at 0.1 ug/ml, whereas that of LNMCs was at 1.0 ug/ml. All of the patients showed greater blastogenic responses for the PPD than those for the TSP. IFN-r, IL-2, and IL-2Ru mRNA production from PBMCs after stimulation with the TSP were greatly augmented after 48 hrs, whereas IL-4 and IL-10 mRNA were gradually suppressed. In addition, high levels of IL-12 p40 mRNA were detected by PBMCs to the TSP antigen at 3 hrs. Elevated IFN-r and IL-2 mRNA production were observed in freshly isolated LNMCs, whereas IL-4 mRNA production was undetectable in either freshly isolated or mycobacterial antigen-stimulated LNMCs. Furthermore, IL-10 mRNA expression from LNMCs was markedly increased by the PPD antigen, but it was considerably reduced by the TSP antigen after 18 hrs. These data suggest that the TSP antigen may be a strong inducer of cytokine mRNA such as IFN-r, IL-2, and IL-12 which are involved in Thl cell and macrophage activation, and inhibit IL-10 mRNA production in LNMCs. In conclusion, the TSP antigen can be used as a preferential Thl cell immunogen in tuberculous lymphadenitis.
Cell Wall ; Humans ; Interleukin-10 ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Lymph Nodes* ; Macrophage Activation ; Mycobacterium tuberculosis* ; Mycobacterium* ; Octoxynol ; RNA, Messenger* ; Tuberculosis ; Tuberculosis, Lymph Node*

It has been known that the immunological functions against cancer cells were diminished, and these phenomena result from the inhibition of cell-mediated immunity by substance(s) secreted from cancer cells. It was also reported that the immunological functions decreased in patients with stomach cancer, which is the most frequent cnacer in Korean. However, the nature and function of the inhibitory factor(s) orignated from stomach cancer have not been identified. To elucidate effects of immuological inhibitory factor(s) secreted from cancer cells, SNU-1 (stomach cancer) and SW480 P109/R3P2 (colon cancer) were used in this study. Jurkat T cell line, an acute T cell leukemia, was pre-incubated with fractionated cancer cell culture supernatant for 3 days, then was stimulated with PMA, PWVanti-CD28 mAb or PMA/ionomycin for 8 hrs respectively. Fraction of SNU-1 (3 - 10 kDa) and above 10 kDa of SW480 P109/R3P2 inhibited the expression of IFN-r mRNA when Jurkat T cell was stimulated with PMA. However, there were no difference in IL-2 and IL-4 gene expression response to either PMA/anti-CD28 mAb or PMA/ionomycin. These results show that cancer cells secret some inhibitory factor(s) acting on the immune response, especially IFN-r gene expression of the Jurkat T cells response to PMA. Therefore, it suggests that the inhibitory factor(s) secreted from cancer cells influences on. the PKC-dependent pathway related to the signal transduction by PMA.
Cell Culture Techniques ; Cell Line ; Gene Expression ; Humans ; Immunity, Cellular ; Interleukin-2 ; Interleukin-4 ; Leukemia, T-Cell ; RNA, Messenger ; Signal Transduction ; Stomach Neoplasms ; T-Lymphocytes

No Abstract Available.
Clone Cells* ; Cloning, Organism* ; Mycobacterium tuberculosis* ; Mycobacterium*

Present study aimed to investigate the immunological activities of cell wall associated protein antigen solubilized with Triton X-100 (TSP) from Mycobacterium tuberculosis H37Rv and conducted on 43 patients with pulmonary tuberculosis (newly diagnosed, medicated within 12 months and chronic refractory patients) and 17 normal healthy controls. These immunological responses were compared with those induced by the PPD or 30 kDa antigen from M, tuberculosis H37Rv culture filtrates, identified as biologically important secreted proteins. Proliferative responses to mycobacterial antigens were compared in peripheral blood mononuclear cells (PBMC) of healthy subjects and pulmonary tuberculosis patients. Signiticant blastogenic responses to the TSP were observed in healthy tuberculin reactors, newly diagnosed and some of antituberculosis drug-medicated patients by H-thymidine incorporation assay. IL-12 p40 and IFN-r mRNA expressions to the TSP were markedly increased, whereas IL-10 and TNF-a mRNA expressions were decreased at a 5 day-stimulation by PBMC in healthy tuberculin reactors, newly diagnosed and medicated patients. However, patients with chronic refractory tuberculosis exhibited more depressed IL-12 p40 and IFN-r mRNA expressions to all of the antigens than another groups. Interestingly, very low IL-10 and TNF-a mRNA expressions cultured with the TSP were also shown. These data suggest that the TSP may be involved in the macrophage activation by induction of Th1 stimulatory signals, such as IL-12, and suppression of Th1 inhibitory cytokine, IL-10.
Tumor Necrosis Factor-alpha

BACKGROUND: The diagnosis of malaria has been usually made using microscopic examination of Wright stained thin blood films in Korean army. This method is labor-intensive, time consuming and requires the microscopic expertise. Therefore, the alternative techniques, rapid diagnostic test, have been sought for use in Korean army. We performed a comparison of the OptiMAL test with GENEDIA Malaria (P. vivax) Ab Rapid I, II to assess its sensitivity and specificity of Plasmodium vivax malaria. METHODS: Blood specimen were collected from 51 patients who were presented and initially diagnosed for P. vivax by the microscopy of blood smears and from 30 control patients without malaria infection at the Capital Armed Forces General Hospital (CAFGH) between October 2000 and February 2001. Among the 51 patients, we also collected 24 samples from 24 patients at 2 or 3 days after therapy. The OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid I, II were performed according to the manufacturer's instructions on all samples respectively. RESULTS: Compared with the blood film, sensitivities and specificities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II were 94.1~100% (29/29), 80.4~83.3%, 96.1~96.7% respectively. One case was interpreted as 'undetermined' by OptiMAL test. In 24 patients during therapy, the sensitivities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II on 8 specimens with mean 120/microliter parasitemia and 16 specimens with negative parasitemia were 75~43.8%, 87.5~81.3%, 100~100% respectively. CONCLUSION: Our data demonstrated that the sensitivity and specificity of the GENEDIA Malaria (P. vivax) Ab Rapid I were not satisfactory, but the sensitivity and specificity of the OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid II were relatively high and useful diagnostic tests for diagnosis of P. vivax in areas like the militaries where laboratory facilities are poor or non-existent.
Arm ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, General ; Humans ; Malaria* ; Malaria, Vivax ; Microscopy ; Military Personnel* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Sensitivity and Specificity

PURPOSE: This study was performed for investigation of epidemiology, clinical characteristics, and serial value of cardiac troponin level of patients who had myocardial injury due to Carbon monoxide poisoning. METHODS: This study reviewed 98 cases of Carbon monoxide poisoning patients who visited Emergency Department from January 1, 2008 to October 31, 2013. We categorized them by two groups, one with elevation of cardiac troponin level and the other with normal level. We had comparison between two groups data using statistical analysis. RESULTS: Among 98 patients of Carbon monoxide poisoning who were admitted to hospital, 10 patients were excluded. 88 patients who were included to our study, 70 patients with normal value of Troponin, and 18 patients with elevated troponin level. Of all patients, Carbon monoxide inhalation due to suicided trial patients has more higher proportion in elevated troponin level group compared with normal group (40 (57.1%) vs 15 (83.3%), P=0.041). Furthermore, corrected QT interval, length of hospital stay, number of ICU admission, also were showed higher value in elevated troponin level group. CONCLUSION: Carbon monoxide induced myocardial injury is associated with subside trial, prolongation of correted QT interval, length of hospital stay, and number of ICU admission.
Carbon Monoxide Poisoning ; Carbon Monoxide* ; Emergency Service, Hospital ; Epidemiology ; Humans ; Inhalation ; Length of Stay ; Reference Values ; Troponin ; Troponin I

OBJECTIVE: The rat middle cerebral artery thread-occlusion model has been widely used to investigate the pathophysiological mechanisms of stroke and to develop therapeutic treatment. This study was conducted to analyze energy metabolism, apoptotic signal pathways, and genetic changes in the hippocampus of the ischemic rat brain. METHODS: Focal transient cerebral ischemia was induced by obstructing the middle cerebral artery for two hours. After 24 hours, the induction of ischemia was confirmed by the measurement of infarct size using 2,3,5-triphenyltetrazolium chloride staining. A cDNA microarray assay was performed after isolating the hippocampus, and was used to examine changes in genetic expression patterns. RESULTS: According to the cDNA microarray analysis, a total of 1,882 and 2,237 genes showed more than a 2-fold increase and more than a 2-fold decrease, respectively. When the genes were classified according to signal pathways, genes related with oxidative phosphorylation were found most frequently. There are several apoptotic genes that are known to be expressed during ischemic brain damage, including Akt2 and Tnfrsf1a. In this study, the expression of these genes was observed to increase by more than 2-fold. As energy metabolism related genes grew, ischemic brain damage was affected, and the expression of important genes related to apoptosis was increased/decreased. CONCLUSION: Our analysis revealed a significant change in the expression of energy metabolism related genes (Atp6v0d1, Atp5g2, etc.) in the hippocampus of the ischemic rat brain. Based on this data, we feel these genes have the potential to be target genes used for the development of therapeutic agents for ischemic stroke.
Animals ; Apoptosis ; Brain ; Brain Ischemia* ; Energy Metabolism ; Gene Expression* ; Hippocampus* ; Ischemia ; Ischemic Attack, Transient ; Middle Cerebral Artery ; Oligonucleotide Array Sequence Analysis ; Oxidative Phosphorylation ; Rats* ; Signal Transduction ; Stroke

Tumor-draining lymph node mononuclear (TDLMN) cells are specifically sensitized to the growing tumor but such cells are deficient for mediating an antitumor response. In this study, we examined the feasibility of using mycobacterial 30 kDa or Triton X-100 solubilized protein (TSP) antigen to stimulate mononuclear cells of colon cancer-draining lymph node for the generation of cell mediated immune effector cells. The proliferative response of TDLMN cells stimulated with mycobacterial 30 kDa or TSP antigen was determined by H-thymidine incorporation assay. The proliferation of TDLMN cells to mycobacterial 30 kDa or TSP antigen was significantly increased in PPD (+) patients, but a poor response to the 30 kDa or TSP antigen was observed in PPD (-). The expression on ro T cells to mycobacterial 30 kDa or TSP antigen was assessed by flow cytometry. The ro T cells from PPD (+) patient responded only to 30 kDa antigen but to TSP antigen. An investigation of cytokine mRNA expression was undertaken using reverse transcription- polymerase chain reaction (RT-PCR) to follow TDLMN cells stimulated with the 30 kDa or TSP antigens for 5 days. The IFN-r and TNF-a mRNA expression was only induced in TDLMN cells of PPD (+) patient in response to the 30 kDa or TSP antigen. The IL-2 mRNA expression was induced in both PPD (+) and PPD (-) in response to the 30 kDa or TSP antigen. But the IL-4 mRNA expression was not induced in response to the 30 kDa or TSP antigen. These results suggest that the 30 kDa and TSP antigens may serve as biologic response modifier for the generation of cell mediated immune effector cells.
Colon* ; Flow Cytometry ; Humans ; Interleukin-2 ; Interleukin-4 ; Lymph Nodes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Negotiating ; Neptune* ; Octoxynol* ; Polymerase Chain Reaction ; RNA, Messenger ; T-Lymphocytes