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 surgical approach to spinal tumors varies not only with the level and location of the tumor, but also with the type and extent of the tumor. Some of the dumbbell neurofibroma(neurilemmoma) can be removed through simple laminectomy, but usually are approached through two separate incisions by two stages. In this report, posterior and anterolateral approaches in a single stage to dumbbell neurofibroma(neurilemmoma) of the spinal region are described. This approach provides full exposure of intra- and paraspinal portions of the tumor, thus permitting safe dissection and total removal. Six patients who underwent this procedure are described to illustrate its application.
Humans ; Laminectomy ; Neurofibroma ; Spine*

BACKGROUND: Bowen's disease is a form of intraepidermal (in situ) squamous cell carcinoma in histopathology, the representative premalignancy of the cutaneous squamous cell carcinoma and is usually persistent and progressive, with a small potential for invasive malignancy by 3-5%. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of Bowen's disease. METHODS: A total of 45 patients with Bowen's disease were enrolled in this study. The hospital charts and histopathological slides were reviewed at Chungnam university hospital from 1983 to 2002. RESULTS: The male and female ratio was 1: 1.14. The mean age at diagnosis was 63 years. Twenty-two cases (58%) of solitary bowen's disease were located in non sun exposed area. Trunck, extremities, genital area followed in decreased order. Sixteen cases (42%) of solitary bowen's diseases occurred on the sun-exposed area. Face, dorsum of hand followed in decreased order. Thirty-three cases(73%) of single lesions and seven cases(27%) of multiple lesion. Analysis of clinical character of the Bowen's disease was performed and results were as follows: the most common type were patch(20 cases; 44%) and plaque (18 cases; 40%). And nodule, ulcer and papule type in decreased order. Analysis of histopathological character of the Bowen's disease was performed and results were as follows: the most common type were psoriasiform(15 cases; 41%) and irregular (12 cases; 32%). And verrucous, atrophic and combined type in decreased order. CONCLUSION: In Bowen's disease among Koreans, there were many distinctive clinical and histopathological features compared to those of non-Korean cases. In Korean cases, Bowen's diseases were located on sun exposed area only 42%, pigmented lesions were 20% and sex ratio 1: 1.14(male: female).
Bowen's Disease* ; Carcinoma, Squamous Cell ; Chungcheongnam-do ; Diagnosis ; Extremities ; Female ; Hand ; Humans ; Male ; Sex Ratio ; Solar System ; Ulcer