Alveolar macrophages participate in the host defense against P. carinii, but the mechanisms in degradation and clearance of the organism from lung has not been well established. We observed the transmission and scanning electron microscopic features and evaluated the expression of TNF-alpha and Surfactant-D in the interaction of P. carinii with alveolar macrophages. Expression of TNF-alpha and Surfactant-D in the experimentally induced P. carinii pneumonia in rat was examined by immunohistochemistry and immunoelectron microscopy. Electron microscopically, the alveolar macrophages phagocytized trophozoites and cysts of P. carinii micro-organisms. Immunohistochemically TNF-alpha was strongly expressed in the cytoplasms of alveolar macrophages. Postembedding immunogold labeling for Surfactant-D protein was expressed on the pellicles of trophozoites and cysts, P. carinii micro-organisms in the cytoplasms of macrophages, free floating surfactant materials and multilamellar bodies of type II epithelial cells. We conclude that alveolar macrophages interacted with P. carinii micro-organisms respond with increased expression of TNF-alpha. TNF-alpha may bind to P. carinii and exert a direct toxic effect upon the micro-organisms. Surfactant-D protein may augment binding of P. carinii to the alveolar macrophages and enhance the clearance of the micro-organisms.
Animals ; Cytoplasm ; Epithelial Cells ; Immunohistochemistry ; Lung ; Macrophages ; Macrophages, Alveolar* ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Rats ; Trophozoites ; Tumor Necrosis Factor-alpha*

No abstract available.
Animals ; Histamine* ; Hydroxyzine* ; Rats* ; Urinary Bladder*

No abstract available.
Tuberculosis, Pulmonary*

Osteopoikilosis is an asymptomatic osteosclerotic dysplasia, initially described by Albers-Schönberg and Ledoux-Lebard and associates. This disorder is described as extremely rare. Inherited and sporadic cases of osteopopikilosis have been reported. A Case of familial osteopoikilosis is presented with a brief review of literatures.
Osteopoikilosis

BACKGROUND AND OBJECTIVES: Traditionally, the treatment of choice for submandibular calculi that lie in the proximal duct or gland parenchyme has been sialadenectomy despite its risk. Recently, minimally invasive techniques including lithotripsy, sialendoscope have been reported, although these techniques have some limitations on large, infected calculi. The aim of this present review is to assess the transoral removal of submandibular calculi. SUBJECTS AND METHOD: The records of a hundred and sixty-three patients who underwent transoral removal of submandibular calculi between January 1, 1995 and July 31, 2004 were retrospectively reviewed. RESULTS: The complete removal of calculi was observed in 147 (90.2%) patients, partial removal with residual calculi in 8 (4.9%) patients and failure of removal in 8 (4.9%) patients. The removal rate of palpable calculi was significantly high. The removal rate of anterior, infection-free calculi was higher than the posterior and infected calculi, but there was no statistical significance. The size of calculi was not related with the removal rate of calculi. A hundred fifty-two (93.3%) of 155 patients in whom some or all of calculi were removed were free of symptoms of calculi. Symptoms were recurred in 19 patients after 2-68 (median 24) months and in 13 patients calculi were removed transorally again. CONCLUSION: The transoral removal of calculi is useful in preservation of the submandibular gland and effective in palpable calculi regardless of location, size, and combined infection.
Calculi ; Humans ; Lithotripsy ; Oral Surgical Procedures ; Retrospective Studies ; Salivary Calculi ; Submandibular Gland

Public interventions have shown to optimize the use of antibiotics in children with acute otitis media (AOM). In this study, we describe the AOM-related antibiotic use among children in South Korea using national cohort data. We retrieved the Health Insurance Review & Assessment Service data to construct a national cohort of children aged 0–6 years who had been diagnosed with AOM between 2012 and 2018. Of 25,212,264 children included, the antibiotic prescription has increased for amoxicillin/amoxicillin-clavulanate from 56.1% in 2012 to 61.8% in 2018. Prescription has decreased for cephalosporin (35.1% in 2012 to 31.8% in 2018) and macrolide (8.7% in 2012 to 6.4% in 2018). National cohort data have shown an increased trend in AOM-related aminopenicillin prescription and downward trend cephalosporin and macrolide use in South Korea. A multi-faceted approach is required to control the antimicrobial resistance at a population level.

Scedosporium(S). apiospermum is the asexual stage of Pseudallescheria boydii. This ubiquitous fungus causes not only mycetoma but also infection of a variety of body sites including the skin. Localized skin infection without grain production due to this organism is much rarer than mycetoma. We report a case of cutaneous S. apiospermum infection which occured in a 75-year old female. She had multiple suppurative nodules with pustules on a dark red plaque at the dorsum of the right forearm. Cultural isolation for definitive diagnosis showed typical S. apiospermum. The patient was treated successfully with oral terbinafine 250mg daily for 1 week and oral itraconazole 200mg daily for 3 weeks.
Aged ; Edible Grain ; Diagnosis ; Female ; Forearm ; Fungi ; Humans ; Itraconazole ; Mycetoma ; Pseudallescheria ; Scedosporium* ; Skin*

Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare disease, which causes chronic progressive inflammation and thickening of the basal dura mater and produces multiple cranial neuropathies, headache, ataxia, and seizure. A 40 year-old man presented with a continuous, diffuse, dull headache with left periorbital pain, exophthalmos, ptosis and loss of visual perception. Brain MRI revealed thickened, highly enhanced pachymeninges in all supratentorial areas in association with the left cavernous sinus. A subsequent meningeal biopsy showed non-specific chronic inflammations of the pachymeninges. The patient dramatically responded to steroid therapy. To our knowledge, this is an extremely rare case of IHCP associated with Tolosa-Hunt syndrome. (J Korean Neurol Assoc 19(1):56~59, 2001
Adult ; Ataxia ; Biopsy ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Dura Mater ; Exophthalmos ; Headache ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Meningitis* ; Rare Diseases ; Seizures ; Tolosa-Hunt Syndrome* ; Visual Perception

The basal cell nevus syndrome is a well recognized entity, the major symptoms of which are basal cell nevi, multiple jaw cysts, skeletal anomalies, and ectopic calcification. The syndrome follows a hereditary pattern, which is characterized by a highly penetrant, autosomal dominant gene with multiple and variable effects. The patient often has a characteristic face, with frontal and temporoparietal bossing, which results in an increased cranial circumference. The eyes may appear widely separated, and 40 percent of patients have true ocular hypertelorism. Jaw cysts are one of the most constant features of the syndrome and are present in at least 75 percent of the patients. The cysts are odontogenic keratocysts and frequently multiple. Radiographically, the cysts in patients with basal cell nevus syndrome do not differ significantly from isolated keratocysts. The cysts in patients with this syndrome are often associated with the crowns of unerupted teeth; on radiographs they may mimic dentigerous cysts. We report a case of multiple odontogenic keratocysts associated with basal cell nevus syndrome with the literature of review.
Basal Cell Nevus Syndrome* ; Crowns ; Dentigerous Cyst ; Genes, Dominant ; Humans ; Hypertelorism ; Jaw Cysts ; Nevus ; Odontogenic Cysts* ; Tooth, Unerupted

BACKGROUND: Androgenetic alopecia (AGA) occurs as a result of progressive miniaturization of scalp hair in genetically predisposed individuals. Several effective treatments for AGA are well known. However, there is a paucity of literature about the influence of such treatments on the frontal hair line (FHL). OBJECTIVE: To assess the effectiveness of oral finasteride and/or topical minoxidil on the FHL. METHODS: An assessment of 100 male patients with AGA of grades II to IV was made, based on the Norwood- Hamilton scale after six months of treatment. The patients were divided into three groups. Group 1 received 1 mg of oral finasteride daily. Group 2 exclusively used 5% minoxidil solution 1 ml twice daily. Group 3 received 1 mg of finasteride daily in combination with a topical application of 5% minoxidil solution. We measured the length from the mid-pupillary line to three points of the FHL with calipers; midpoint of the forehead, and right and left temporal recession, respectively. RESULTS: An improvement of the FHL was observed in all of three groups. There was a tendency for patients taking only finasteride to show an overall improvement in the frontal hair line, while patients applying only minoxidil solution showed an improvement in both temporal recession lines. Comparing the three groups at three points of the FHL respectively, at both temporal recession of the FHL, Group 3 showed the best result, followed by Group 2, and finally Group 1. The center of the FHL Group 3 showed the best result, followed by Group 1, and finally Group 2. CONCLUSION: We found that the combination therapy of finasteride and minoxidil had a synergic effect on FHL in the treatment of androgenetic alopecia. In the assessment of treatment efficacy to the FHL of patients with AGA, the method of using calipers in this study was worthwhile.
Alopecia* ; Finasteride ; Forehead ; Hair* ; Humans ; Male ; Miniaturization ; Minoxidil ; Scalp ; Treatment Outcome