The experiment was performed to investigate changes of maternal immune status during the pregnancy. We observed the distribution of several immune cells [macrophage, activated B-cell, IgM+ B-cell, Lyt-2+ T-cell and L3T4+ T-cells] in the utero-placental interface and the peripheral blood of Balb/c mice. The experimental animals were divided into seven groups by the gestational ages ; virgin, 2nd, 5th, 8th, 10th, 14th and 19th day of pregnancy. In the utero-placental interface, the distribution patterns of the lymphocytes [both T and B] and macrophages were observed. Histochemical staining by naphthol-AS-MX phosphate sodium salt was used for the detection of activated B-cells. For the detection of macrophage, plasma cell, suppressor cell and helper cell, all the prepared samples reacted with Rat anti-mouse Mac-1, goat anti-mouse IgM, rat anti-Lyt2 and rat anti-L3T4 antibody first, and washed. Second reaction was done with biotinylated anti-rat or anti-mouse IgG anti-bodies, and washed. Avidin-biotin -peroxidase complex and 3, 3`-diamino-benzidine[DAB] were used for the visualization of specific cells. T-cells and B-cells were not observed during the all stages of pregnancy. By contrast, macrophages were observed a few at the perimetrium on the second day of gestation, and they were found at the outermost portion of the trophoblastic layer on the 8th day, and they were observed at the decidua basalis in late pregnancy after the 10th day when the placenta were well developed. In the peripheral blood, activated B-cells were not observed throughout the pregnancy. On the 8th day, the proportion of plasma cells to total mononuclear cells was decreased significantly to 16+/-2.4% compared with the virgin group[22+/-2.6%][p<0.01]. It increased again and it reached 42+/-5.8% on the 14th day and 37+/-4.9% on the 19th day. Helper T-cells were decreased on the 14th day[30+/-2.4%] compared with the normal control[47+/-5.1%]. But, Suppressor T-cells were increased on the 8th day[35+/-2.9%] and the 10th day[33+/-3.6%] compared with the normal controls[27+/-2.3%]. This decrement returned to the level of the normal controls on the 14th day and 19th day. Together with our previous data, we could find the synchronized changes of immune cells in utero-placental interface, uterus draining lymph nodes, peripheral blood and spleen. Therefore, we suggest that macrophages in utero-placental interface may play an important role for the immune responses against the fetal transplantation antigen.
Animals ; B-Lymphocytes* ; Decidua ; Female ; Gestational Age ; Goats ; Immunoglobulin G ; Immunoglobulin M ; Lymph Nodes ; Lymphocytes ; Macrophages* ; Mice* ; Placenta ; Plasma Cells ; Pregnancy ; Rats ; Sodium ; Spleen ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Trophoblasts ; Uterus

Esophageal ulcers induced by doxycycline is a rare complication. These patients usually complain of sudden onset of symptoms, ie acute substernal or chest pain and odynophagia without prior hietory of esophageal syraptoms. On esophagoscopic examination, there are upper or midesophageal ulcers, which heal after diseontinuation of the drug within 2 weeks. A history of ingestion of the doxycycline,with liquid jost before bedtime can be elicited. The exact eause of the xaucosal ulceration is not clear, but a direct irritant effeet on esophageal mucosa seems most likely. We report 5 cases of esophageal uleeration secondary to the ingestion of doxycydine. Esophagoscopy revealed esophageal ulcers in all patients and the patients hecame asymptomatic following stopping of tbe drugs and taking antacids.
Antacids ; Chest Pain ; Doxycycline* ; Eating ; Esophagoscopy ; Humans ; Mucous Membrane ; Ulcer*

Carbon monoxide (CO) poisoning is the most common cause of fatal poisoning in the United States and may be the most common worldwide cause of fatal poisoning. CO poisoning can affect the entire body and usually causes neurologic or cardiac injury. While not common, rhabdomyolysis, skeletal muscle necrosis, and renal failure can also occur. We report on a suicidal 22-year-old man who inhaled CO gas from a burning briquette. His case was complicated by compartment syndrome (CS). Finally, he had to undergo fasciotomy and removal of necrotic muscle. A CO poisoned patient who is unconscious cannot describe symptoms and moderate swelling or tenderness might be neglected. Though CS rarely appears in CO poisoning, delayed diagnosis may result in fatal consequences. Therefore, in the case of an unconscious patient, the entire body must be examined closely to identify early signs related to CS (tenderness, swelling, redness). If the diagnosis is uncertain after the clinical evaluation, the pressure within the compartment should be measured.
Burns ; Carbon Monoxide ; Carbon Monoxide Poisoning* ; Compartment Syndromes* ; Delayed Diagnosis ; Diagnosis ; Humans ; Muscle, Skeletal ; Necrosis ; Poisoning ; Renal Insufficiency ; Rhabdomyolysis ; United States ; Young Adult

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest* ; Humans ; Hypothermia* ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; Sensitivity and Specificity

No abstract available.
Zygoma*

The objective of this study was to provide basic reference data for stabilization scheme of medical insurance benefits through forecasting of the medical care utilization rate, the medical expense per case, and the treatment days per case in medical insurance program for government employees and private school teachers and for industrial workers. For the achievement of above objective, this study was carried out by Bos-Jenkins time series analysis (ARIMA Model), using monthly statistical data from Jan. 1979 to Dec. 1989, of medical insurance program for government employees and private school teachers and for industrial workers. The results are as follows; ARIMA model of the medical care utilization rate in medical insurance program for government employees and private school teachers was ARIMA (1, 1, 1) and it for outpatient in medical insurance program for industrial workers was ARIMA (1, 1, 1), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the medical expense per case in medical insurance program for government employees and private school teachers and for outpatient in medical insurance program for industrial workers were ARIMA (1, 1, 0), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the treatment days per case of both medical insurance program for government employees and private school teachers and industrial workers were ARIMA (1, 1, 1). Forecasting value of the medical care utilization rate for inpatient in medical insurance program for government employees and private school teachers was 0.0061 at dec. 1989, 0.0066 at dec. 1994 and it for outpatient was 0.280 at dec. 1989, 0.294 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 0.0052 at dec. 1989, 0.0056 at dec. 1994 and it for outpatient was 0.203 at dec. 1989, 0.215 at 1994. Forecasting value of the medical expense per case for inpatient in medical insurance program for government employees and private school teachers was 332,751 at dec. 1989, 354,511 at dec. 1994 and it for outpatient was 11,925 at dec. 1989, 12,904 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 281,835 at dec. 1989, 293,973 at dec. 1994 and it for outpatient was 11,599 at dec. 1989, 11,585 at 1994. Forecasting value of the treatment days per case for inpatient in medical insurance program for government employees and private school teachers was 13.79 at dec. 1989, 13.85 at dec. 1994 and it for outpatient was 5.03 at dec. 1989, 5.00 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 12.23 at dec. 1989, 12.85 at dec. 1994 and it for outpatient was 4.61 at dec. 1989, 4.60 at 1994.
Forecasting ; Humans ; Inpatients ; Insurance Benefits ; Insurance* ; Moclobemide* ; Outpatients

The exact incidence of esophagitis in gastroesophageal reflux disease (GERD) remains poorly understood in Korea. To determine incidence of esophagitis in GERD, from August 1988 to July 1993, endoscopy, esophageal manometry with Bernstein test, and ambulatory 24 hour esophageal pH monitoring were carried out in a group of 349 patients with symptoms of heartburn or noncardiac chest pain. Based on these studies, 151(40%) patients had some degree of GERD and pstients were categorized as having: pathologic reflux, 98 patients; symptomatic reflux, 42 patients; and sensitive mucosal reflux, 11 patients. Among 151 patients with GERD, 27 patients(18%) had some degree of esophagitis. In conclusion, 40% of patients with symptoms suggestive of GERD have GERD. GERD is divided into subgroups; pathologic reflux, symptomatic reflux, and mucosal sensitive reflux. Less than 20% of GERD have esophagitis or esophageal mucosal injury and these low incidence of mucosal injury in Korean may be due to increased esophageal mucosal resistance.
Chest Pain ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis* ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Incidence* ; Korea ; Manometry

To measure the mutagenic activity of micro-organic pollutants in drinking water, mutagenic test was conducted using Salmnella typhimurium TA 98 strain on the water sample taken from three water supply station and six tap water in Seoul in July and November 1987. The results were as follows : 1. The average amounts of organic matters in raw, treated, and tap water sampled in July were 0.38mg/l, 0.28mg/l, and 0.45mg/l, respectively, and sampled in November were 0.34mg/l, 0.24mg/l, and 0.22mg/l, respectively. The amount of organic matters of tap water sampled in November did not increase while that of tap water sampled in July increased compare to those of raw or treated water. 2. The amount of organic matters is the highest in neutral fraction compare to acidic and basic fractions. 3. In the five out of six tap water and raw water of Paldang and Kuui station sampled in July, the mutagenic ratios were greater than two (both direct and indirect mutagenicity). 4. In the three out six tap water and raw and treated water of Kuui station sampled in November, the mutagenic ratios were greater than two. 5. While mutagenic were low in acidic and basic fraction, they were high in neutral fraction. The samples which had high mutagenic activity in the total amount also showed high mutagenic activity in neutral fraction. 6. While mutagenic activity was decreased after the treatment of water, it was increased in tap water as the distance from the water supply station increases.
Drinking Water* ; Drinking* ; Seoul* ; Water ; Water Supply

We observed the effect of application of n-PTFE on mandibular bone defects in the rabbit. GTR is based on the hypothesis that during wound healing, non-osteogenic cells are mechanically blocked from entering a bone defect. This allows the slower-migrating mesenchymal cells from the surrounding bone and marrow, having osteogenic potential, to move the defect site. Bilateral through & through defects, 8mmx4mm in size, involving the inferior border of mandible, were created in the mandible angle of 15 rats. The experimental side was applied with high-density n-PTFE membrane, with the opposite side serving as a control. In the first week of the early experimental period, the bone defects of experimental groups were filled with highly vascularized fibrous connective tissue showing prominent osteoblastic activity with osteoid formation, whereas the defects of control were replaced by dense fibro-muscular tissue without osteoblastlf activity. After 3 weeks, the experimental group revealed well formed bone trabeculae and fibro-vascular marrow within surrounding membrane. With time the amount of new bone was decreased with increase of hematopoietic marrow, and the cortical plate composed of dense mature bone was more thicker. In the whole experimental periods, the inflammation and foreign body reaction were not found around the inserted n-PTFE membrane. After removal of membrane there was marked remodeling of newly formed bone by active osteoclasts in periosteal soft tissue, which decreased the bone volume apparently. These findings suggest that n-PTFE has biocompatibility, flexibility, and rigidity and offer rapid bone regeneration within limited area by the membrane. On the other hand, the early removal of membrane caused reduction of bone volume by the osteoclastic resorption. Thus, the time of removal may be more important factor for maintenance of regenerated bone volume.
Animals ; Bone Marrow ; Bone Regeneration ; Connective Tissue ; Foreign-Body Reaction ; Hand ; Inflammation ; Mandible ; Membranes ; Osteoblasts ; Osteoclasts ; Pliability ; Rabbits* ; Rats ; Wound Healing

PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*