Tumor-draining lymph node (TDLN) lymphocytes contain immunologically sensitized to tumor but functionally deficient T cells. The 30 kDa protein antigen, a major secreted protein antigen of Mycobacterium tuberculosis, exhibits strong T cell stimulatory effect. In this study, it examined that the feasibility of using M tuberculosis 30 kDa antigen to stimulate tumor-draining lymph node cells for the generation of specific immune effector cells. Freshly isolated TDLN lymphocytes could directly respond to the 30 kDa antigen alone and their proliferative responses were markedly augmented by stimulation with rIL-2. TDLN cells were stimulated with the 30 kDa antigen for various time intervals and examined for the induction of IFN-r and IL-4 mRNA using RT-PCR. The expression of IFN-r mRNA was greatly augmented after 1 wk, whereas IL-4 mRNA is markedly decreased after 1 wk. Cytotoxic T cell activities induced by the 30 kDa antigen was also evaluated. TDLN cells stimulated with the 30 kDa antigen alone were able to generate remarkable cytotoxic response to K562 or Daudi cell lines after 6 days of culture. And their cytotoxic effects were highly augmented by stirnulation with rIL-2. These results suggest that the 30 kDa antigen of M. tuberculosis may selectively activate Thl cells of TDLN lymhocytes and induce the cytotoxic T cell activities. In conclusion, the 30 kDa antigen can be used as a biologic response modifier in tumor immunology.
Allergy and Immunology ; Cell Line ; Interleukin-4 ; Lymph Nodes* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; T-Lymphocytes ; Th1 Cells* ; Tuberculosis

To evaluate the usefulness of indocyanine green (ICG) iris angiography in darkly pigmented iris and to investigate whether the anterior segment ischemia can be produced by tenotomies of two or more rectus muscles in rabbits, twenty one eyes of 21 pigmented rabbits wer divided into four groups according to the surgical procedures. Group I (2 eyes) underwent only conjunctival peritomy as a control. Group II (6 eyes), Group III (9 eyes), Group IV (4 eyes) underwent tenotomies of two, three and four rectus muscles, respectively. All these eyes underwent ICG iris angiography at pre-op, post-op 10 housrs, 3 days, 7 days and 14 days. In eight eyes of Group I and Group II, fluorescein iris angiography was taken simultaneously. The quality of fluorescein iris angiography was much lower in the pigmented iris and the interpretation was more difficult compared to ICG iris angiography. The peritomy (Group I) or tenotomies of two rectus muscles (Group II) produced no circulatory defect of the iris even after 10 hours postoperatively. After tenotomies of three rectus muscles (Group III) there were transient mild filling defects in superior or inferior sector of iris in 7 of 9 eyes. These defects lasted for 1 to 3 days. Tenotomies of four rectus muscles (Group IV) produced transient filling defects which lasted for 1 to 7 days. ICG iris angiography was suitable for the evaluation of anterior segment circulation in darkly pigmented iris, thus, it can be applied to the coriental brown iris. And in contrast to the previous concept that the rabbits iris arteries derive solely from the long posterior ciliary arteries, circulatory disturbance of iris, even though transient, could be produced by severance of rectus muscles.
Angiography* ; Arteries ; Ciliary Arteries ; Fluorescein ; Indocyanine Green* ; Iris* ; Ischemia* ; Muscles ; Rabbits* ; Tenotomy

Purpose: To evaluate the risk factors for the development of osteonecrosis in civilian professional divers by an epidemiologic study and to determine the correlation between osteonecrosis in divers and coagulopathy by analysis of serologic markers that are related to thrombophilia and hypofibrinolysis. Materials and Methods: Forty-two divers, who collected pen shells (Atrina pinnata), and among whom 10 had osteonecrosis (group 1), were compared with 32 divers without osteonecrosis (group 2). Both groups were evaluated based on the number of years of diving experience, number of dives per year, mean number of dives per day, mean diving time and depth, and diving methods. We determined any statistically significant differences among these variables. We measured the levels of serologic markers that were related to hyperlipidemia, thrombophilia, and hypofibrinolysis from the divers and a control group of 20 physicians (group 3). The levels of the serologic markers were compared between groups 1 and 2 and between the divers and the control group, in order to determine the relationship between the serologic markers and the development of dysbaric osteonecrosis. Results: None of the variables demonstrated any statistically significant differences, except for the mean diving time, in which group 1 had a mean diving time of 124 minutes and group 2 had a mean diving time of 62.1 minutes (P<0.05). In the analysis of the serologic markers, there were no statistically significant differences between groups 1 and 2; however, in comparison with the group 3, the divers demonstrated significantly decreased activity levels of proteins C and S (Protein C: P<0.05; Protein S: P<0.05), and an increase in the levels of plasminogen activator inhibitor-1 (PAI-1) (P<0.05). Conclusion: The divers with osteonecrosis had a longer mean diving time than did those divers without osteonecrosis. In the serologic marker analysis, the divers with osteonecrosis demonstrated significantly decreased activity levels of Proteins C, S and a significant increase in the levels of PAI-1, compared with the control group.
Biomarkers* ; Diving ; Epidemiologic Studies* ; Epidemiology ; Hyperlipidemias ; Osteonecrosis* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein S ; Risk Factors ; Thrombophilia

PURPOSE: The purpose of this study is to compare CO2 DSA and nonionic contrast media angiography in respect to the quality of the opacification of collaterals and incidence of side-effects in peripheral occlusive arterial disease. MATERIALS AND METHODS: Sixteen patients who were suspected to have peripheral occlusive arterial disease were performed angiography with nonionic contrast media and CO2 at the same location with the same catheter. The causes of the lesions were atherosclerosis(n=7) and Buerger's disease(n:9). CO2 DSA was compared with nonionic contrast media angiography in respect to the quality of image in the diagnosis of the lesions, opacifications of collaterals and side-effects. RESULTS: In atherosclerosis;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 6 patients and was poor in 1 patient;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 5 patients and was poor in 2 patients. In Buerger's disease;quality of the images of CO2 DSA was same as that of nonionic contrast media angiography in 2 patients and was poor in 7 patients;opacifications of collaterals of CO2 DSA were same as that of nonionic contrast media angiography in 1 patient and was poor in 8 patients. Leg pain was the only side-effect after CO2 injection occuring in 4 out of 16 patients. CONCLUSION: CO2 could be used as safe contrast media in patient with risk factors for nonionic contrast media and for diagnosis of the atherosclerosis in lower extremity. For the procedures such as vascular intervention reguiring large amount of contrast media CO2 could effectively replace nonionic contrast media.
Angiography* ; Atherosclerosis ; Catheters ; Contrast Media ; Diagnosis ; Humans ; Incidence ; Leg ; Lower Extremity* ; Risk Factors

No abstract available.
Dermatitis, Allergic Contact

OBJECTIVE: The presence of an intracerebral hematoma from a ruptured aneurysm is a negative predictive factor and it is associated with high morbidity and mortality rates even though clot evacuation followed by the neck clipping is performed. Endovascular coil embolization is a useful alternative procedure to reduce the surgical morbidity and mortality rates. We report here on our experiences with the alternative option of endovascular coil placement followed by craniotomy for clot evacuation. MATERIALS AND METHODS: Among 312 patients who were admitted with intracerebral subarachnoid hemorrhage during the recent three years, 119 cases were treated via the endovascular approach. Nine cases were suspected to show aneurysmal intracerebral hemorrhage (ICH) on CT scan and they underwent emergency cerebral angiograms. We performed immediate coil embolization at the same session of angiographic examination, and this was followed by clot evacuation. RESULTS: Seven cases showed to have ruptured middle cerebral artery (MCA) aneurysms and two cases had internal carotid artery aneurysms. The clinical status on admission was Hunt-Hess grade (HHG) IV in seven patients and HHG III in two. Surgical evacuation of the clot was done immediately after the endovascular coil placement. The treatment results were a Glasgow Outcome Scale score of good recovery and moderate disability in six patients (66.7%). No mortality was recorded and no procedural morbidity was incurred by both the endovascular and direct craniotomy procedures. CONCLUSION: The results indicate that the coil embolization followed by clot evacuation for the patients with aneurysmal ICH may be a less invasive and quite a valuable alternative treatment for this patient group, and this warrants further investigation.
Treatment Outcome ; Tomography, X-Ray Computed ; Retrospective Studies ; Middle Aged ; Male ; Intracranial Aneurysm/radiography/*therapy ; Humans ; Hematoma/radiography/*therapy ; Female ; Embolization, Therapeutic/*methods ; Drainage/*methods ; Cerebral Angiography ; Aneurysm, Ruptured/radiography/*therapy ; Adult

STUDY DESIGN: The authors reviewed the dural tears in the thoracolumbar fractures treated surgically. OBJECTIVES: To evaluate the incidence and the predictive values for the presence of dural tears in the thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Many authors reported that the dural tear was usually related to the thoracolumbar fractures especially with laminar fracture and neurologic deficit. The dural tears may lead complications such as the entrapment of spinal nerve root, delayed wound healing, cerebrospinal fluid fistula, and myelomeningocele. Previous reports emphasized posterior approach to confirm and treat the dural tears using laminectomy. So it is very important that surgeons should identify the presence of dural tear preoperatiyely to determine the surgical approach and treatment options. MATERIALS AND METHODS: The authors reviewed 22 patients of thoracolumbar fractures treated with posterior laminectomy, posterior decompression, posterolateral fusion, and instntmentation from August 1993 to August 1996. The follow-up period was minimally 12 months. We checked the canal compromise, the injury of the posterior column including laminar fracture and ligamental injury, and neurologic deficits as the predictive values. The statistical analysis was done to evaluate the relationship between the dural tear and the predictive values. RESULTS: The incidence of dural tear was 54.4% of the thoracolumbar fractures. The canal encroachment, the injury of the posterior column, and the neurologic deficits were not significantly related with the dural tears in statistical analysis. But we could find the tendency that is related to the dural tear and posterior column injury. CONCLUSION: The authors concluded that we could find the possible presence of dural tears in the severe thoracoiumbar which were needed the surgical treatment and we could suggest the injury of posterior column was a possible value that could predict the presence of dural tear.
Cerebrospinal Fluid ; Decompression ; Fistula ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Ligaments ; Meningomyelocele ; Neurologic Manifestations ; Spinal Nerve Roots ; Tears* ; Wound Healing

No abstract available.
Humans

For the interpretation of the confocal laser scanning indocyanine green angiography(Heidelberg Retina Angiograph, HRA) in patients with choroidal neovascularization(CNV) secondary to age-related macular degeneration(AMD), we analyzed the early and the late phase images comparatively. HRA was carried out in 41 eyes of 36 patients that revealed occult CNV or undetectable CNV on fluorescein angiograms. In all patients, the image qualitites of HRA was excellent in the early as well as in the late phase studies and CNV was detected in 38 eyes(93%). In 25 eyes(66%), we could get all the possible information of CNV with the early phase images which revealed CNV as fine neovascular networks or vascular structures of lnear or dot pattern usually surrounded by hypofluorescent margins. And when the hypofluorescent margin surrounded the neovascular structure completely, a well-defined CNV could be diagnosed. In 9 eyes(24%), more accurate evaluation of the nature, size and geometry of CNV could be made with the help of more late phase images. In these cases, as the initially identified neovascular structures were stained in the late phase, more intensely leaking portions or more widespread minimally stained areas could be detected. In remaining 4 eyes(10%), CNV could b detected in the late phase without apparent evidence of vascular structure in the early phase. Our study suggests that careful reading of the whole sequence of ICG angiograms and comparative analysis of the early and late phase images are required to get the clinically useful information from HRA.
Angiography* ; Choroid* ; Choroidal Neovascularization* ; Fluorescein ; Humans ; Indocyanine Green* ; Retina

PURPOSE: Bipolar hemiarthroplasty of the hip has been used as a treatment modality for displaced femoral neck and intertrochanteric fractures in elderly patients, inflammatory and degenerative diseases of the hip, osteonecrosis of femoral head and limb salvage procedure after tumor resection. Because of the intrinsic stability of the biarticular structure, it is also used for treatment of recurrent dislocation after total hip replacement arthroplasty. However, despite its intrinsic stability, dislocation does occur even after bipolar hemiarthroplasty, and poor prognosis after the dislocation has been reported. So, we tried to investigate the incidence, risk factors, treatment and preventive methods of dislocation after bipolar hemiarthroplasty. MATERIALS AND METHODS: We reviewed 138 patients and 138 bipolar hemiarthroplasties retrospectively to analyze the incidence, timing, risk factors, treatment and preventive methods of the dislocation. RESULTS: The incidence of dislocation was 5.8% (8/138). Female gender, intertrochanteric fracture, pre-existing neuromuscular disorders including cerebrovascular accident, long period of pre-operative and postoperative immobilization were statistically significant (P<0.05) as a risk factor. Related muscular weakness was the most significant predisposing factor for dislocation. CONCLUSIONS: In order to prevent dislocation after bipolar hemiarthroplasty performed in the patients with above risk factors, we must try and encourage early operation, early ambulation, muscle strengthening exercise and application of abduction hip brace.
Aged ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Braces ; Causality ; Dislocations* ; Early Ambulation ; Female ; Femur Neck ; Head ; Hemiarthroplasty* ; Hip Fractures ; Hip* ; Humans ; Immobilization ; Incidence ; Limb Salvage ; Muscle Weakness ; Osteonecrosis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke