Adenosine deaminase (adenosine aminohydrolase, AL)A), which catalyzes the deamination of adenosine to yield inosine and amrnonia, was assayed in human penile foreskin. The skin tissue was separated into two layers; epidermis and dermis. They were sliced with scissors into gel state, 4 volumes of 0.05M phosphate buffer solution were added and the tissue homogenized. After centrifugation at 4,000xg for 5 minutes, the supernatant was used as an enzyme solution. ADA activity was measured according to the method f Giuseppe" ADA was found to be present in both layers (epidermis; 0.24 OD/mg protein, dermis; 0.19 OD/mg protein) with slightly higher activity in the epidermis. As in earlier reports, it was found that ADA in the skin showed nearly even activity in the pH range of 5.0-8.0. Considering the significance of ADA in immunological function, the presence of ADA in the skin suggests that the tissue may participate in the immune function.
Adenosine Deaminase* ; Adenosine* ; Centrifugation ; Deamination ; Dermis ; Epidermis ; Foreskin ; Humans* ; Hydrogen-Ion Concentration ; Inosine ; Skin*

We have experienced a case of congenital esopageal atresia which was confirmed by autopsy. A 3 days old female infant, birth weight 2,300gm, length 48cm, was admitted to Dept. of Pediatrics, Chonnam University Medical school because of poor sucking power, fever and vomiting. On admission, she was kept in an incubator and whole milk was giver per oral, followed by immediate vomiting and regurgitation through mouth and nose, accompanied by dyspnea and cyanosis. A Nelaton catheter was inserted through the esophagus but met a solid obstructed region at 15cm from the nares. A plain abdomen showed no air in the upper gastrointestinal tract, and in esophagogram with air and Dionocil, esophageal atresia without tracheoesophageal fistula was shown. Gastrostomy was performed but 6 days after operation, she expired. The autopsy findings revealed blind pouched upper esophagus with dilatation at 2nd thoracie spine level and blind pouched lower esophagus just below the diaphragm. A brief review of related literature is also noted.
Abdomen ; Autopsy ; Birth Weight ; Catheters ; Cyanosis ; Diaphragm ; Dilatation ; Dyspnea ; Esophageal Atresia* ; Esophagus ; Female ; Fever ; Gastrostomy ; Humans ; Incubators ; Infant ; Jeollanam-do ; Milk ; Mouth ; Nose ; Pediatrics ; Schools, Medical ; Spine ; Tracheoesophageal Fistula ; Upper Gastrointestinal Tract ; Vomiting

No abstract available.

No abstract available.
Estrogens, Conjugated (USP)* ; Hypersplenism*

OBJECTIVES: Although bronchoscopy is an important diagnostic tool for lung disease, patients compliance is low due to discomfort. Recently, midazolam which has a favorable anterograde amnesia effect and short action duration, has been used to relieve patients discomfort during bronchoscopy. Midazolam was investigated in order to see the beneficial effect and safety during bronchoscopy. METHODS: The study design was single blind, randomized, prospective. 102 patients were included, in whom bronchoscopy was performed between June, 19% and October, 1995 at Samsung Medical Center. They were categorized into midazolam group and control group. Patients were asked about the amnesic effect, discomfort of procedure and the willingness to repeat procedure. The consciousness level of patients during procedure, patient cooperation during procedure and ease of procedure were also reported by bronchoscopists. RESULTS: 1) The difference of oxygen saturation between two groups: There was no significant difference in oxygen saturation between midazolam group and control group before and after bronchoscopy. During procedure, however, mean oxygen saturations in midazolam group (90+/-6.4%) was significantly lower than in control group (93+/-4.7%)(p<0.05). 2) Evaluations by patients (1) Effect of amnesia: 41 patients (82%) in midazolam group could not recall the procedure but 52 patients (100%) recalled the entire procedure in control group. A favorable amnesic effects could be found in midazolam group(p<0.05). {2) The discomfort during the procedure: 43 patents(86%) did not experience discomfort from procedure in midazolam group but 25 patients(48%) complained of discomfort in control group (p<0.05). (3) Most patients except two(96%) were willing to repeat fiberoptic bronchoscopy in midazolam group but 13 patients (25%) answered that they would never repeat bronchoscapy. There was a statistically significant difference between two groups in the willingness to repeat bronchocopy (p<0.05). 3) The evaluations by bronchoscopists Cooperations of the patients and ease of procedure were not different between two groups. The patients in midazolam group except eight could not respond to verbal stimuli but most patients were awakened during procedure in control group(p<0.05). CONCLUSION: Midazolam is a good sedative agent for a patient to give a favorable amnesia, reduction of discomfort during bronchoscopy. We concluded that midazolam is a safe and useful sedative agent and midazolam may be used routinely during bronchoscopy. Monitoring of oxygen saturation, however, is essential to prevent severe hypoxia during procedure.
Amnesia ; Amnesia, Anterograde ; Anoxia ; Bronchoscopy* ; Compliance ; Consciousness ; Humans ; Lung Diseases ; Midazolam* ; Oxygen ; Patient Compliance ; Prospective Studies*

BACKGROUND: We have recently reported that airway epithelial cells can produce RANTES and IL-8 in response to the stimulation of tubercle bacilli wuggesting a certain role of airway epithelial cells in the pathogenesis of pulmonary tuberculosis. The pathogenesis of tuberculosis is determined by several factors including phagocytosis, immunological response of host, and virulence of tubercle bacilli. Interestingly, there have been reports suggesting that difference in immunological response of host according to the virulence of tubercle bacilli may be related with the pathogenesis of tuberculosis. We, therfore, studied the expressions and productions of RANTES and IL-8 in airway epithelial cells in response to tubercle bacilli(H37Rv, virulent strain and H37Ra, avirulent strain), in order to elucidate the possible pathophysiology of pulmonary tuberculosis. METHODS: Peripheral blood monocytes were isolated from normal volunteers. Peripheral blood monocytes(OBM) were stimulated with LPS(10 micrograms/ml), H37Rv, or H37Ra(5X10(5) bacilli/well) along with normal control for 24 hours. A549 cells were stimulated with supernatants of cultured PBM for 24 hours. ELISA kit was used for the measurement of TNFalpha and IL-1beta production in supernatants of cultured PBM and for the measurement of RANTES and IL-8 in supernatants of cultured A549 cells. Northern blot analysis was used for the measurement of RANTES and IL-8 mRNA expression in cultured A549 cells. RESULTS: TNFalpha and IL-1beta productions were increased in cultured PBM stimulated with LPS or tubercle bacilli(H37Rv or H37Ra) compared with the control. There was, however, no difference in TNFalpha and IL-1beta production between cultured PBM stimulated with H37Rv and H37Ra. RANTES and IL-8 expressions and productions were also increased in cultured A549 cells stimulated with LPS or tubercle bacilli compared with the control. RANTES and IL-8 mRNA expressions were significantly increased in cultured A549 cells stimulated with H37Ra-conditioned media(CM) compared with A549 cells stimulated with H37Rv-CM (p<0.05). However, there was no difference in RANTES and IL-8 productions between A549 cells stimulated with H37Rv-CM and H37Ra-CM. CONCLUSION: Airway epithelial cells can produce the potent chemokines such as RANTES and IL-8, in response to the stimulation of tubercle bacilli. These results suggest that airway epithelial cells may play a certain role in the pathogenesis of pulmonary tuberculosis. However, the role of airway epithelial cells in the pathogenesis of tuberculosis according to the virulence of tubercle bacilli was not clear in this study.
Blotting, Northern ; Chemokine CCL5 ; Chemokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Healthy Volunteers ; Interleukin-8 ; Monocytes ; Phagocytosis ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pulmonary ; Tumor Necrosis Factor-alpha ; Virulence*

BACKGROUND: Klebsiella pneumoniae is an opportunistic pathogen which causes a spectrum of extra- intestinal infections. Since early 1980s, many outbreaks of extended-spectrum beta-lactamase (ESBL) producing K. pneumoniae have been reported. Using quinolone as an alternative therapeutic antibiotics also induced increased resistance to quinolones. Therefore, we evaluatedted the clinical and microbiological features of pneumonia caused by quinolone-resistant K. pneumoniae (QRKP). METHODS: From March of 1998 to April of 2000, 345 cases of K. pneumoniae pneumonia had been admitted to Korea University Guro Hospital. We retrospectively reviewed medical records of 75 cases. Thirty patients with pneumonia due to QRKP (case patients) were compared to 45 patients with pneumonia due to quinolone-susceptible K. pneumoniae (QSKP: control patients). We also performed antimicrobial susceptibility test (disc diffusion method and agar dilution method) and RAPD (random amplified polymorphic DNA) analysis to differentiate the isolates in resistant strains. RESULTS: Of 345 episodes of pneumonia, 30 (8.7 %) were caused by QRKP. Multivariate analysis re-vealed that prior antibiotics use was an independent risk factor for QRKP pneumonia. Among prior antibiotics, quinolone and the third generation cephalosporin were independently related to quinolone resistance. Although mortality rate was not high, QRKP pneumonia was associated with a significantly longer treatment duration and poor treatment response (P=0.009 and 0.007 respectively). According to the antimicrobial susceptibility test, quinolone resistance was significantly associated with the multi-drug resistance. RAPD analysis showed that 28 quinolone resistant strains belonged to only 4 genotypes, suggesting that patient- to-patient transmission of a few strains within the hospital occurred. CONCLUSION: QRKP pneumonia had a significant impact on clinical outcome and quinolone resistance was associated with multiple resistance to other antibiotics. It should be emphasized that judicious use of antibiotics as well as barrier precautions is required to reduce future outbreak and spread of QRKP.
Agar ; Anti-Bacterial Agents ; beta-Lactamases ; Diffusion ; Disease Outbreaks ; Drug Resistance, Multiple ; Genotype ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Medical Records ; Mortality ; Multivariate Analysis ; Pneumonia* ; Quinolones ; Retrospective Studies ; Risk Factors

Herpetic meningoencephalitis is a devastating disease with significant morbidity and mortality. One of the most serious clinical sequelae is aphasia, usually of sensory type, whereas, Broca's or motor aphasia is not a common manifestation. We report a case of herpetic meningoencephalitis diagnosed by polymerase chain reaction (PCR) and viral culture with Broca's aphasia as a neurologic sequela. A 35-year old male patient was admitted due to fever and altered mentality for 3 days. He was accompanied by nausea, vomiting, disorientation, and memory defect. Several vesicular eruptions were noted around the lips. Neck stiffness was present, but Kernig's and Brudzinski signs were not observed. Herpetic meningoencephalitis was confirmed with PCR and other diagnostic tests such as EEG, brain MRI, brain CT scan, and viral culture. His overall clinical condition was improved after acyclovir therapy, but Broca's aphasia remained as a sequela.
Acyclovir ; Adult ; Aphasia* ; Aphasia, Broca ; Brain ; Diagnostic Tests, Routine ; Electroencephalography ; Encephalitis, Herpes Simplex* ; Fever ; Herpes Simplex* ; Humans ; Lip ; Magnetic Resonance Imaging ; Male ; Memory ; Mortality ; Nausea ; Neck ; Polymerase Chain Reaction ; Tomography, X-Ray Computed ; Vomiting

No abstract available.
Mononeuropathies* ; Systemic Vasculitis ; Vasculitis*

BACKGROUND: Measles is an acute highly contagious infection caused by measles virus. Since the introduction of measles vaccines in 1963, measles has been dramatically decreased in Korea. However, measles outbreaks have occurred periodically every 4 to 6 years during the 1990s. During 2000, measles outbreak of large scale occurred throughout the country and the total of 32,088 cases were reported. The majority of affected population was infants and school-aged children, but measles was reported also among adolescent and adult population. There was no report about the epidemiology of adult measles cases during the last decade. In this study, we retrospectively analyzed the epidemiologic and clinical features of adult measles patients in Korea. METHODS: From July of 2000 to January of 2001, 50 adult cases of measles had been admitted to Korea University Hospital. Medical records of these 50 patients, who were clinically diagnosed as measles, were reviewed. Demographic data, clinical features, history of measles vaccination and laboratory findings were evaluated. RESULTS: The median age of patients was 23 years : 28 (56%) were male. Most cases (49/50, 98%) occurred between November of 2000 to January of 2001 and 8 (16%) patients were associated with outbreaks. The occupation of patients was diverse but, students (28%) and office workers (20%) were the most common. 44 (88%) of 50 patients had no underlying diseases. Adult measles patients demonstrated similar clinical symptoms, which were shown in children with measles. In laboratory findings, mean WBC count was 4,933/micro L and 18 (36%) patients had thrombocytopenia. 21 (42 %) patients had complication of measles, and hepatitis was the most common episodes among them. Measles vaccination history revealed that 5 (10%) had two-dose and 7 (14%) had one-dose measled vaccine. In 35 patients, measles IgM antibody test was done. It appears that IgM positive rate among one-dose measle vaccination group, two-dose measle vaccination group, and group with unknown vaccination history were 86% (6/ 7), 40% (2/5), and 78% (18/23), respectively. Most (94%) of patients were hospitalized and more than two-third of patients were isolated. All the patients were recovered without sequelae. CONCLUSION: In 2000 measles outbreak, adult measles had the typical clinical features similar to those in the children and the severe complication was rare. Adult measles patients demonstrated low measles vaccination rate and occurred mainly among the students and office workers.
Adolescent ; Adult* ; Child ; Disease Outbreaks ; Epidemiology ; Hepatitis ; Humans ; Immunoglobulin M ; Infant ; Korea ; Male ; Measles virus ; Measles* ; Medical Records ; Occupations ; Retrospective Studies ; Thrombocytopenia ; Vaccination ; Vaccines