OBJECTIVE: To investigate whether the serum levels of IL-10 in patients with rheumatoid arthritis are different from those of normal controls and SLE patients and to find out any correlation with disease activity parameters of rheumatoid arthritis. METHODS: Sera from 20 healthy normal persons, 16 rheumatoid arthritis patients and 16 patients with systemic lupus erythematosus were collected and measured for IL-10 and IL-6. Various disease activity parameters were measured in RA patients. RESULTS: The serum level of IL-10 in RA patients was significantly elevated compared to normal controls but lower than those of SLE patients. In RA patients there was no definite correlation between the disease activity parameters and serum IL-10 levels. Despite significant improvements in terms of various disease activity parameters, there was no significant change of serum IL-10 levels after treatment in RA patients. In seropositive RA patients, positive correlation was found between serun IL-10 and rheumatoid factor levels. CONCLUSION: Our findings show that the serum IL-10 levels in patietns with RA are elevated compared to normal controls but lower than those of SLE patients. There was no correlation between serum IL-10 levels and disease acivity parameters of RA.
Arthritis, Rheumatoid* ; Humans ; Interleukin-10* ; Interleukin-6 ; Lupus Erythematosus, Systemic ; Rheumatoid Factor

To evaluate the results and clinical impact of defecography in patients with anorectal diseases, 304 defecographic examinations from 304 patients were reviewed. The defecographic results were screened for the anorectal angle and perineal descent at rest, squeezing and during straining. Changes of rectal configuration and canal width during straining were reviewed. 304 patients had defecation problems such as terminal constipation, defecation defficulty, blood or mucus discharge, tenesmus, obstruction sensation etc. They were performed anorectal physical examination and anal manometry etc., and were later treated by operation and conservative management. Normal anorectal angle were measured to be 101°, 91°, 131°at rest, during squeezing and straining respectively. In the spastic pelvic floor syndrome, increase of anorectal angle less than 10 ° from rest to straining was observed. Incontinent patients had a larger anorectal angle (mean: 128°) at rest. 7.8cm of perineal descent was found in descending perineal syndrome in comparison to 4.0cm in normal. Normal anal canal width was measured 1.4cm only during straining but identified in incontinent patients at rest (mean:1.2cm). Abnormal rectal configuration was found in 254 defecographic examinations: rectoceles were observed in 235 cases and were associated with rectal prolapse in 115 cases, and rectal prolapses were found in 134 cases. In conclusion, the anorectal angle was valuable in evaluation of spastic pelvic floor syndrome and fecal incontinence. Degree of perineal descent was abnormally increased in descending perineal syndrome. In the cases of the rectoceles and rectal prolapses, defecography is helpful in preoperative evaluation of rectal wall change and postoperative follow up.
Anal Canal ; Constipation ; Defecation ; Defecography* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Mucus ; Muscle Spasticity ; Pelvic Floor ; Physical Examination ; Rectal Prolapse ; Rectocele ; Sensation

The Odontoid process fracture has been treated by prolonged external immobilization of by internal fixation and fusion. We reported congential and traumatic odontoid process fracture which were successfully treated by transoral fusion. Operative preparation, technique and postoperative management are described by in detail.
Immobilization ; Odontoid Process*

No abstract available.
Constriction, Pathologic*

BACKGROUND: Phospholipase D (PLD) is a widely distributed enzyme that hydrolyzes phosphatidylcholine, a major phospholipids in the cell membrane, to form phosphatidic acid (PA) which acts by itself as a cellular messenger. PLD can also be transformed by PA phosphohydrolase into diacylglycerol (DAG), which is essential for the activation of protein kinase C (PKC). PLD has been shown to induce the proliferation of T cells and to activate by Der p 1 in peripheral blood mononuclear cells from atopic dermatitis. Single nucleotide polymorphism (SNP) has recently served as a key marker to discover the genetic mechanism of special chronic diseases. METHODS: One hundred eighteen children with atopic dermatitis were recruited, and graded as 23 mild (<25), 48 moderate (25-50) and 47 severe (>50) by measuring SCORAD index. Genomic DNA were purified from blood and made into PCR primers attaching GC-Clamp, and 26 exons of PLD were amplified by PCR-DGGE (denaturing gradient gel electrophoresis). RESULTS: Polymorphism was found in four subjects. Of them, three PLD1 cSNP (Exon23: G2658A, T2664A, G2684A) were detected in exon 23 of 26 exons of PLD1. Four cases among 118 subjects had cSNP of G2658A (3.4%), two T2664A cases (1.7%), one G2684A case (0.8%). There were no significant correlations between IgE and detected cSNP. CONCLUSION: Three PLD1 gene cSNPs (G2658A, T2664A, G2684A) were detected in the blood of children with atopic dermatitis. Among them, G2658A polymorphism seems to be correlated to the serum IgE level, but PLD1 cSNP does not appear to contribute to the pathogenic processing of atopic dermatitis.
Cell Membrane ; Child* ; Chronic Disease ; Dermatitis, Atopic* ; DNA ; Exons ; Humans ; Immunoglobulin E ; Phosphatidic Acids ; Phosphatidylcholines ; Phospholipase D ; Phospholipases* ; Phospholipids ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Protein Kinase C ; T-Lymphocytes

PURPOSE: Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy. METHODS: Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection. RESULTS: 78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups. CONCLUSION: AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.
Azathioprine ; Humans ; Immunosuppression* ; Incidence ; Kidney Transplantation ; Transplantation* ; Tuberculosis ; Wound Infection

Basal cell carcinomas(BCCs) are the most common skin cancers in Korea and a proportion of BCCs contain pigment. Pigmented basal cell carcinomas(PBCCs) are included in the differential diagnosis of invasive melanoma and other benign pigmented skin lesions(PSLs) because of their growth patterns and asymmetry of pigmentation. Epiluminescence microscopy(ELM) describes the non-invasive in vivo examination of skin lesions with a microscope using incident light delivered from an acute angle and oil immersion. Many studies have shown that epiluminescence microscopy can improve the diagnostic accuracy of PSLs. Menzies et al analyzed the morphologic features of a large set of 142 pigmented BCCs and produced a simple ELM method for diagnosis that would allow differentiation from melanomas and benign pigmented lesions. We observed morphologic features of two PSLs with a handheld 10 epiluminescence microscopy (Episcope, Welch Allyn Inc, Skaneateles Falls, NY). After the ELM examination, two PSLs were excised and processed for histopathology. The ELM findings and histopathologic diagnosis were compared for each lesion. ELM permits the recognition of two PBCCs and the fact that it is a non-invasive in vivo method makes it even more attractive as a diagnostic tool in clinical practice.
Carcinoma, Basal Cell* ; Dermoscopy* ; Diagnosis ; Diagnosis, Differential ; Immersion ; Korea ; Melanoma ; Pigmentation ; Skin ; Skin Neoplasms

Methotrexate (MTX) has been widely used in the treatment of psoriasis and rheumatoid arthritis. But prolonged use of MTX can induce hepatic fibrosis and even cirrhosis. To date, in Korea, there have been very few reports on hepatotoxicity due to MTX, and no report on biopsy-proven chronic active hapatitis. We report one patient who developed chronic acitve hepatitis while taking long-term daily dose of MTX(10mg per day) for psoriasis for a prolonged period.
Arthritis, Rheumatoid ; Fibrosis ; Hepatitis ; Hepatitis, Chronic* ; Humans ; Korea ; Methotrexate* ; Psoriasis*

Henoch-Schonlein purpura(HSP) is an IgA mediated immune complex vasculitic disease characterized by non-thrombocytic purpura, arthritis, gastrointestinal manifestations, and glomerulonephritis. HSP related glomerulonephritis induces hypoproteinemia and edema in some cases. Protein-losing enteropathy is another rare but known manifestation of HSP leading to hypoproteinemia and edema. We report a 6-year-old girl with HSP who showed edema caused by intestinal protein loss, evidenced by elevated fecal alpha 1 antitrypsin clearance.
alpha 1-Antitrypsin ; Antigen-Antibody Complex ; Arthritis ; Child ; Edema ; Female ; Glomerulonephritis ; Humans ; Hypoproteinemia ; Immunoglobulin A ; Protein-Losing Enteropathies* ; Purpura ; Purpura, Schoenlein-Henoch*

PURPOSE: To correlate high-resolution CT (HRCT) findings with smoking history and pulmonary function test (PFT) in patients with idiopathic pulmonary fibrosis (IPF) with or without coexisting emphysema. MATERIALS AND METHODS: The study included 24 patients who had undergone HRCT and in whom IPF had been confirmed pathologically (n=7) and clinically (n=17). The patients included 19 men and 5 women aged between from 44 and 78 (mean 59) years. HRCT findings were reviewed by two radiologists and assessed for the presence and extent of emphysema (CT emphysema score ; CES) and honeycombing (CT honeycombing score ; CHS). CES and CHS were retrospectively correlated with smoking status and pulmonary function test. RESULTS: Evidence of emphysema was seen on HRCT in 20 of 24 patients with IPF (83 %). CES was 14.3 and CHS was 18.1 in smokers with IPF, as compared with 1.8 and 6.7 in nonsmokers (p < 0.01). Pulmonary function tests showed lower percent predicted FEV1 (69.3 %), FVC (64.7 %), TLC(73.7 %), and RV (77.3 %), a lower percent predicted diffusing capacity of carbon monoxide (58.2%), and normal FEV1/FVC (99.1%). The pulmonary function test in smokers showed higher TLC and RV than in nonsmokers. Eight of nine patients whose CES was higher than their CHS, as seen on HRCT, were smokers and had a smoking history of 33.1 pack-years. Seven of 15 whose CHS was higher than their CES were smokers and had a smoking history of 16.8 pack-years. In patients with a higher CES than CHS pulmonary function test results showed normal TLC (85 %) and RV (100.7%) ; this contrasted with decreased TLC (72 %) and RV (68 %) in patients whose CHS was higher than their CES. CONCLUSION: Emphysema is a frequently associated finding in patients with IPF, as seen on HRCT, and emphysema is more frequent and extensive in smokers with IPF than non-smokers. HRCT is useful for detecting emphysema in patients with IPF, and the extent of emphysema on HRCT correlates with the results of the pulmonary function test and smoking status.
Carbon Monoxide ; Emphysema* ; Female ; Humans ; Idiopathic Pulmonary Fibrosis* ; Male ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking