Macrophage colony-stimulating factor (M-CSF) is known as one of the factors essential for osteoclast development. In the present study, we examined effects of M-CSF on the apoptotic pathway of osteoclast precursors and their underlying molecular mechanisms. Osteoclast precursors underwent apoptosis in the absence of M-CSF, even in the presence of receptor activator of NF-kB ligand (RANKL). Active caspase-3 and -9 were detected in the osteoclast precursors and treatments of precursors with their specific inhibitors (Z- DEVD-FMK and Z-LEHD-FMK) decreased the apoptosis. M-CSF decreased apoptosis in a dose-dependent manner with decreasing in active caspases-3 and -9 levels and up-regulating Bcl-XL. Those effects of M-CSF on inhibiting apoptosis of osteoclasts precursor by regulating anti-apoptotic signals was more effective when combined with RANKL. These results demonstrate that M-CSF acts as a survival factor for the osteoclast precursors. Furthermore, it is believed that the apoptosis of osteoclast precursors may be involved in the activation of caspase-9 and that M-CSF may promote their survival through Bcl-XL-induced inhibition of caspase-9 activation.
Animals ; Apoptosis/drug effects/physiology ; Carrier Proteins/pharmacology ; Caspases/antagonists & inhibitors/drug effects/metabolism ; Cell Survival/drug effects ; Cells, Cultured ; Cysteine Proteinase Inhibitors/pharmacology ; Enzyme Activation/drug effects ; Female ; Macrophage Colony-Stimulating Factor/*pharmacology ; Membrane Glycoproteins/pharmacology ; Mice ; Mice, Inbred ICR ; Oligopeptides/pharmacology ; Osteoclasts/*cytology/drug effects ; Proto-Oncogene Proteins c-bcl-2/drug effects/*metabolism ; Stem Cells/cytology/*drug effects ; Up-Regulation

This paper describes a new method to create an animal model for TMJ internal derangement in the New Zealand white rabbits and the light and electron microscopical changes of posterior attachment of them. Twenty six rabbits(2.5-3.0kg), four normal and twenty two experimental, were used. The right disc of experimental animal was displaced anteriorly without sectioning the posterior attachment and tied to the zygomatic arch with nylon not to be reduced to the original position. The left TMJ was sham-operated to be compared with its right experimental one. Normal animals were sacrificed one day and eight weeks after experiment. Experimental animals were sacrificed one day, ten days, three weeks, five weeks and eight weeks after surgery respectively. They were fixed intravenously with 2% glutaldehyde under general anesthesia and the samples of them were processed for light and electron microscopic examination. The purpose of this experiment is to make a suitable animal model of disc displacement without reduction for studying and understanding the cellular and morphologic events in posterior attachment of TMJ including early changes which were difficult to be observed in human TMJs. The results of this investigation suggest the following conclusions: 1. Authors induced anterior disc displacement surgically in rabbits with new method to examine histologic changes of posterior attachment. Tissue reactions of this model seem to be similar to those observed in human disc displacement. We think this animal model for anterior disc displacement may be used to explore and evaluate objectively the effects of many treatment modalities in disc displacements. 2. The animal disease model showed inflammation at early stage(one and ten days). At this stage there were mild-to-severe mononuclear inflammatory cell infiltration, numerous newly formed vessels, vessel dilatation and engormement and many fibroblasts. 3. At middle stage(three weeks), fibrosis occurred, where fibroblasts decreased in number, but their cytoplasm was profuse indicating high activity. Collagen fibers increased in number and the tissue looked more dense. 4. At late stage(five weeks and eight weeks) showed degenerative changes including perforation of posterior attachment, disintegration of collagen fiber bundles, degeneration of fibroblasts, metastatic ossification, and dystrophic calcification.
Anesthesia, General ; Animals ; Collagen ; Cytoplasm ; Dilatation ; Disease Models, Animal ; Fibroblasts ; Fibrosis ; Humans ; Inflammation ; Models, Animal ; Nylons ; Rabbits* ; Temporomandibular Joint* ; Zygoma

Aspergilloma and Allergic Bronchopulmonary Aspergillosis(ABPA) are different types of the pulmonary aspergillosis spectrum of diseases. ABPA is an inflammatory disease that causes hypersensitivity to Aspergillus spores growing in the bronchi, which is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia and central bronchiectasis. Aspergilloma is a simple colonization of fungus within a cavitary lung lesion, but these diseases rarely coexist. A case of ABPA, coexistent with Aspergilloma, was experienced in a 31 year-old female. The diagnosis was confirmed by the immediate cutaneous reactivity to Aspergillus fumigatus, elevated total IgE antibodies, peripheral eosinophilia, bronchiectasis, growth of Aspergillus species in a sputum culture and radiographic infiltration. Treatment, with prednisone and itraconazole, led to improvement of the respiratory symptoms, reduction of the cavitary lesion and in the total serum IgE level.
Adult ; Antibodies ; Aspergillosis, Allergic Bronchopulmonary* ; Aspergillus ; Aspergillus fumigatus ; Asthma ; Bronchi ; Bronchiectasis ; Colon ; Diagnosis ; Eosinophilia ; Female ; Fungi ; Humans ; Hypersensitivity ; Immunoglobulin E ; Itraconazole ; Lung ; Prednisone ; Pulmonary Aspergillosis ; Spores ; Sputum

Until now, tight-fitting material, such as a ring on a digit, has been treated primarily using ring cutter techniques. If this was not available, most physicians would attempt to pull materials out using simple instruments available in the emergency room. The material selected most often was lubricant. However, for cases in which the tight-fitting material was unusual in that the finger was fully covered so that the joint or distal part could not be located in order to check on complications, there have been no methods for consideration with references. Therefore, we treated a patient whose finger was stuck in an unusual circumstance, and removed it manually using the lubricant and compressor technique.
Emergencies ; Fingers ; Humans ; Joints

PURPOSE: To report on the treatment approach of canaliculitis related to SmartPLUG use and its clinical manifestation. METHODS: A retrospective chart review of eight patients who had canaliculitis after the insertion of the SmartPLUG was conducted. RESULTS: Seven out of eight cases with canaliculitis related to the SmartPLUG required extraction of the SmartPLUG. While four cases were removed with only retrograde massage, two cases required surgical treatment. CONCLUSIONS: Canaliculitis related to SmartPLUG use is rarely reported. However, canaliculitis as a complication is difficult to treat and often leads to surgery. In canaliculitis related to SmartPLUG use, retrograde massage as a non-surgical method for the simple and effective removal of the SmartPLUG can be beneficial.
Corneal Ulcer ; Dacryocystitis ; Humans ; Massage ; Retrospective Studies ; Canaliculitis

Thymic carcinoid or neuroendocrine tumor of thymus is a very rare disease and has poor prognosis due to frequent recurrence and distant metastasis. A 43-year-old man was refered to our hospital because of Rt. chest pain and tightness. Chest X-ray revealed 7 X 8cm sized mass on Rt. anterior mediastinum. Surgical excision was performed and light microscopic, immunohistochemical and electron microscopic findings were confirmed as atypical thymic carcinoid tumor with thymic cyst. The patient has been followed up without recurrence or distant metastasis postoperatively for 3 months to now. We report a case of atypical thymic carcinoid with thymic cysts.
Adult ; Carcinoid Tumor* ; Chest Pain ; Humans ; Mediastinal Cyst* ; Mediastinum ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Prognosis ; Rare Diseases ; Recurrence ; Thorax ; Thymus Gland

BACKGROUND: Influenza is a highly contagious respiratory disease. Influenza virus, which causes epidemics every winter season, has the high possibility of appearing with new virus types every year due to antigen variation. Therefore, we intended to analyze the data on the epidemiology of influenza that had been acquired by laboratory surveillance in Incheon during the 2003/2004 and 2004/ 2005 seasons and to apply the knowledge to the control and prevention of influenza in Korea. METHODS: Specimens were inoculated into Madin-Darby canine kidney (MDCK) cells and, when cytopathic effect (CPE) was seen, culture supernatants were tested by mutiplex RT-PCR for typing and subtyping of influenza viruses. RESULTS: The first virus of the season was isolated at week 47 (3rd week on November) in 2003 during 2003/2004 and at week 43 (4th week on October) in 2004 during 2004/2005, which was about 4 weeks earlier than in the 2003/2004 season. From 532 specimens cultured for influenza virus during the 2003/2004 season. 330 (62.0%) viruses were isolated: 161 (48.8%) A/H3N2, 1 (0.3%) A/H1N1, and 168 (50.9%) B. During 2004/2005 season, 457 specimens were tested and 278 (60.8 %) were positive for influenza virus: 232 (83.5%) A/H3N2, 5 (1.8%) A/H1N1, and 38 (13.7%) B. The incidence of influenza was the highest in the school-age children and young adults of 7 to 19 years age group in both seasons. CONCLUSION: Influenza virus was isolated at a high rate (more than 60%) by the laboratory influenza surveillance system in Incheon during the 2003/2004 and 2004/2005 seasons: the predominant strain was influenza A/H3N2 subtype.
Antigenic Variation ; Child ; Epidemiology ; Humans ; Incheon* ; Incidence ; Influenza, Human* ; Kidney ; Korea ; Orthomyxoviridae ; Seasons ; Young Adult

The purpose of this study is to assess the usefulness of digital infrared thermographic image(DITI) in patients with surgically treated lumbar disc disease. A series of 480 patients with lumbar herniated disc was studied. The mean age of the patients was 37 years, with a range of 18 to 64 years. Of which 126 cases of chemonucleolysis. 18 cases of percutaneous endoscopic laser discectomy, and 336 cases of laminectomy with discectomy were performed. Among these patients, 336 cases of laminectomy were assessed by DITI preoperatively. The thermal differences(delta T) between the symptomatic and asymptomatic limbs were evaluated. We have categorized the types of herniations into 3 classes: 200 protruded, 99 extruded, and 37 sequestered. The thermal differences were classified into 3 groups: 177 patients had delta T < 0.5 degrees C, 74 patients had 0.5 degrees C < or = delta T < 0.8 degrees C and 85 patients had delta T > or = 0.8 degrees C. Among the group of patients with the sequestered disc, 30(i.e. 80%) had delta T > or = 0.8 degrees C. Among the surgically treated 336 patients, non-visualization of a part of the sciatic limb on preoperative DITI was the condition used to coin the term amputation sign by the authors. In the sequestered group, the "amputation sign" was observed in 28 cases(75%). We conclude that DITI can predict a sequestered disc disease, and it allows more precise indication regarding open surgery.
Amputation ; Diskectomy ; Extremities ; Humans ; Intervertebral Disc Chemolysis ; Intervertebral Disc Displacement ; Laminectomy ; Numismatics

A 13-year-9-month-old female child presented with congenital kyphoscoliosis along with progressive paraparesis. Radiographs confirmed kyphoscoliosis and magnetic resonance imaging revealed a stretched and flattened spinal cord over the kyphotic deformity and a T7 hemivertebra. She underwent a posterior correction of the curve along with posterior decompression and a posterior to anterior excision of T7 hemivertebra to relieve her of the deteriorating neurology. While carrying out the excision of T7 hemivertebra, her trans cranial electrical motor evoke potential dropped. Consequently, she was administered a mega dose steroid therapy. After a positive wake-up test, the excision was discontinued and surgery was concluded by in situ fixation of the deformity with short rods. Thereafter, a gradual deterioration in the neurologic status was observed and patient became paraplegic on the fourth post operative day. In this case report, we try to analyze various causes for gradual deterioration in neurologic status.
Child ; Congenital Abnormalities ; Decompression ; Evoked Potentials, Motor ; Female ; Humans ; Kyphosis ; Lifting ; Magnetic Resonance Imaging ; Neurology ; Paraparesis ; Paraplegia ; Spinal Cord

Osteoprotegerin (OPG), a member of the tumor necrosis factor receptor superfamily, is known to inhibit osteoclastogenesis by acting as a soluble decoy receptor for the receptor activator of NF-kB ligand (RANKL). We report the presence of OPG on the membrane of osteoclasts and the possibility of the direct action of OPG on them. Highly pure osteoclast precursors were isolated from mouse long bones and induced to differentiate into mature osteoclasts by M-CSF and soluble RANKL (sRANKL). The presence of OPG on the membrane of these cells was confirmed by western blotting and immunostaining. Furthermore, sRANKL was found to be bound to the OPG on the osteoclast precursors. These results suggest that OPG might have a new role during the differentiation of osteoclasts beyond its role as a soluble decoy receptor. The mechanism of the existence of OPG on osteoclast precursors remains to be found.
Animals ; Bone and Bones/cytology/*metabolism ; Carrier Proteins/immunology/metabolism ; Cell Differentiation/drug effects/physiology ; Cell Membrane/*metabolism ; Cells, Cultured ; Glycoproteins/drug effects/*metabolism ; Macrophage Colony-Stimulating Factor/pharmacology ; Membrane Glycoproteins/immunology/metabolism ; Mice ; Mice, Inbred ICR ; Osteoclasts/drug effects/*metabolism ; Receptors, Cytoplasmic and Nuclear/drug effects/*metabolism ; Stem Cells/drug effects/metabolism