No abstract available.
Herpes Zoster* ; Herpesvirus 3, Human ; Magnetic Resonance Imaging* ; Zoster Sine Herpete*

Present study was aimed to investigate the immunological activities of the 47 kDa protein antigen from Treponema pallidum and conducted on 12 patients with syphilis (early, late, spontaneously healed, congenital and treated patients) followed by therapy. Peripheral blood mononuclear cells (PBMC) were obtained three times from each patient, on admission before the initiation of therapy, 1 and 6 months later. Eleven (96.7%) of the patients prior to therapy, showed depressed lymphoproliferative responses to the 47 kDa antigen (stimulation index <4) by 3H-thymidine incorporation assay. However, these T cell responses were seemed to be transient because most of the patients (63.6%) exhibited significantly higher lymphoproliferation after therapy. Before therapy, PBMC from spontaneously healed syphilis patients resulted in significantly increased gene expression of IFN- and proinflarnmatory cytokines, such as TNFa, IL-1B and IL-6, in response to the 47 kDa. Patients with late latent and late congenital syphilis exhibited lower IFN-r and proinflammatory cytokine mRNA expression than spontaneously healed syphilis group did. After therapy, IFN-r and proinflammatory cytokine mRNA expressions were gradually reduced in these groups. On the other hand, IFN- and proinflammatory cytokine gene expressions were considerably depressed in early syphilis patients, but these patients went on to express prominent IFN-r and proinflamrnatory cytokine mRNA with treatment. These data suggest that the pattern of cellular immune response in response to the 47 kDa antigen may be involved in the evaluation of the clinical course and outcome of syphilis followed by therapy.
Cytokines ; Flow Cytometry ; Follow-Up Studies* ; Gene Expression ; Hand ; Humans ; Immunity, Cellular ; Interleukin-6 ; RNA, Messenger ; Syphilis ; Syphilis, Congenital ; Treponema pallidum* ; Treponema*

Present study was aimed to investigate the immunological activities of the 47 kDa glycoprotein antigen from Treponema pallidum and conducted on 24 patients with syphilis, (early, late, spontaneously healed, congenital and treated patients) and on 17 normal healthy controls. Two opposite lymphoproliferative manifestations to the 47 kDa antigen were observed in syphilis patients by H-thymidine incorporation assay. Ten responders (stimulation index [Sl] >4) showed a 3-fold-higher proliferation than the nonresponders, and four of those responders were spontaneously healed patients. Furthermore, analysis by flow cytometry indicated a preferential expansion of CD4' T lymphocytes by the 47 kDa antigen in the spontaneously healed syphilis patients. Stimulation of PBMCs of spontaneously healed syphilis patients with the 47 kDa antigen for greater than 72 hrs resulted in piogressive augmentation of IFN-r, IL-2Ra and IL-2 mRNA measured by RT-PCR, but considerably reduced IL-4 and IL-10 mRNA expression. However, patients with late latent syphilis exhibited more increased IL-4 and IL-10 mRNA expressions in response to the 47 kDa antigen than spontaneously healed syphilis group. In contrast to other groups, when cultured with the 47 kDa antigen very low IFN-#y, IL-2Ra and IL-2 mRNA expressions were shown in early syphilis group. These data suggest that the Th1-predominant cellular responses induced by the 47 kDa antigen may be involved in the clinical outcome of syphilis and provide the immunologic basis for further functional studies regarding the role of the 47 kDa in the immunopathogenesis of syphilis.

BACKGROUND AND OBJECTIVES: Dizziness has been known as a prognostic factor in sudden sensorineural hearing loss (SSHL), but it is difficult to describe and quantify its subjective symptoms. Also, dizziness itself cannot imply vestibular dysfunction in SSHL. Comprehensive evaluation of vestibular function may help us understand the extent of lesions in sudden deafness. The purpose of this study is to determine whether an impaired caloric response is associated with disease severity and hearing outcome. SUBJECTS AND METHOD: A retrospective chart review was conducted of 488 patients diagnosed as unilateral SSHL. The patients were divided into two, an abnormal caloric group (canal paresis >20%) and normal caloric group (canal paresis ≤20%). Initial demographic and audiologic findings and final hearing outcomes were compared between the two groups. RESULTS: The initial pure tone averages of SSHL patients of abnormal caloric group and normal caloric group were 75.4±28.4 dB HL and 68.2±25.4 dB HL (p=0.004), respectively. Patients of abnormal caloric test group showed worse hearing outcome across all frequencies compared to those of the normal caloric group. Also, a significant correlation was noted between the magnitude of hearing recovery and canal paresis (r=-0.223, p < 0.001). CONCLUSION: SSHL patients of abnormal caloric test showed worse initial hearing level and poorer hearing outcome. Evaluation of vestibular function in SSHL patients is important because subjective symptoms alone cannot account for vestibular hypofunction patients, and the caloric test can help in the counseling of patients and prediction of hearing outcome in SSHL patients.
Caloric Tests* ; Counseling ; Dizziness ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden* ; Humans ; Methods ; Paresis ; Retrospective Studies

BACKGROUND: It has recently been reported that atopic disorders are associated with various neurological diseases. Atopic myelitis (AM) has been defined as an idiopathic myelitis with either (1) an atopic disease such as atopic dermatitis, allergic rhinitis, or bronchial asthma, or (2) positive mite antigen-specific immunoglobulin E (IgE) with hyper-IgE-emia. The aim of this study was to characterize the clinical, radiological, and laboratory profiles of AM. METHODS: The characteristics of a group of patients with AM (n=18) were compared with those of a group of non-AM subjects (n=13). The history, clinical symptoms, serologic and cerebrospinal fluid (CSF) findings, and brain and spinal-cord magnetic resonance imaging (MRI) scans of all of the subjects were reviewed. RESULTS: Clinically, nonacute onset occurred more frequently in the AM group than in the non-AM group (72.2% vs. 30.8%, p=0.033). The positivity of specific IgG antibody to Toxocara canis was greater in the AM group than in the non-AM group (p=0.045). Swelling (p=0.001) and gadolinium enhancement (p=0.014) on MRI was also more prevalent in the AM group. There was tendency toward a greater proportion of males, purely sensory symptoms, a higher recurrence rate, and eosinophilia in the AM group than in the non-AM group. CONCLUSIONS: These findings suggest that AM is responsible for a considerable proportion of cases with idiopathic myelitis. It appears that the progression of symptom onset is slower, the positivity of specific IgG antibody to Toxocara canis higher, and the occurrence of swelling and enhancement of the lesion on spinal-cord MRI is more prevalent among those with AM than those without.
Asthma ; Brain ; Dermatitis, Atopic ; Eosinophilia ; Gadolinium ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins ; Magnetic Resonance Imaging ; Male ; Mites ; Myelitis ; Recurrence ; Rhinitis ; Rhinitis, Allergic, Perennial ; Toxocara ; Toxocara canis

BACKGROUND AND OBJECTIVES: Bone conduction (BC) auditory brainstem response (ABR) is an important factor in determining the type of hearing loss especially in infants and other difficult-to-test populations. However, multiple constraints including technical difficulties make evaluating BC ABR less feasible in the clinic, and there is also lack of information that guides clinicians how to evaluate it. The purpose of this study is to compare the latency of wave V in BC and air conduction (AC) ABR in normal hearing infants and gather reference values for wave V latency of BC ABR. SUBJECTS AND METHOD: A total of 210 ears of normal hearing, of those not belong to the hearing loss risk group, were included. All the infants underwent ABR evoked by clicks via AC (3A insert phone) and BC (Radioear B-71, vibrator positioned on the mastoid) under sedation. The latency of wave V at 30 dB nHL by BC and AC was compared and analyzed according to age. RESULTS: The results revealed that in every age group in the study, wave V latency at 30 dB nHL of BC ABR was shorter than that of AC ABR. There was a significant decrease in BC and AC latencies with age, but among each consecutive age group, significant latency change was not identified after 6 months old. CONCLUSION: The latency of BC ABR in young children was shorter than that of AC ABR, and it decreased significantly as age increased. However, the reference data should be considered by taking each laboratory's test parameter into consideration.
Bone Conduction* ; Child ; Ear ; Evoked Potentials ; Evoked Potentials, Auditory, Brain Stem* ; Hearing Loss ; Hearing* ; Humans ; Infant* ; Reference Values

BACKGROUND: Recent studies have revealed that C-peptide induces smooth muscle cell proliferation and causes human atherosclerotic lesions in diabetic patients. The present study was designed to examine whether the basal C-peptide levels correlate with cardiovascular risk in type 2 diabetes mellitus (T2DM) patients. METHODS: Data was obtained from 467 patients with T2DM from two institutions who were followed for four years. The medical findings of all patients were reviewed, and patients with creatinine >1.4 mg/dL, any inflammation or infection, hepatitis, or type 1 DM were excluded. The relationships between basal C-peptide and other clinical values were statistically analyzed. RESULTS: A simple correlation was found between basal C-peptide and components of metabolic syndrome (MS). Statistically basal C-peptide levels were significantly higher than the three different MS criteria used in the present study, the Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program's (NCEP's), World Health Organization (WHO), and the International Diabetes Federation (IDF) criteria (NCEP-ATP III, P=0.001; IDF, P<0.001; WHO, P=0.029). The multiple regression analysis between intima-media thickness (IMT) and clinical values showed that basal C-peptide significantly correlated with IMT (P=0.043), while the analysis between the 10-year coronary heart disease risk by the United Kingdom Prospective Diabetes Study risk engine and clinical values showed that basal C-peptide did not correlate with IMT (P=0.226). CONCLUSION: Basal C-peptide is related to cardiovascular predictors (IMT) of T2DM, suggesting that basal C-peptide does provide a further indication of cardiovascular disease.
Adult ; Atherosclerosis ; Biomarkers ; C-Peptide ; Cardiovascular Diseases ; Carotid Arteries ; Cholesterol ; Coronary Disease ; Creatinine ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Great Britain ; Hepatitis ; Humans ; Inflammation ; Myocytes, Smooth Muscle ; World Health Organization

No abstract available.
Atherosclerosis ; Biomarkers ; C-Peptide ; Humans

Interleukin (IL)-27 is a novel cytokine of the IL-6/IL-12 family that has been reported to be involved in the pathogenesis of autoimmune diseases and has a pivotal role as both a pro- and anti-inflammatory cytokine. We investigated the in vivo effects of IL-27 on arthritis severity in a murine collagen-induced arthritis (CIA) model and its mechanism of action regarding control of regulatory T (Tregs) and IL-17-producing T helper 17 (Th17) cells. IL-27-Fc-treated CIA mice showed a lower severity of arthritis. IL-17 expression in the spleens was significantly decreased in IL-27-Fc-treated CIA mice compared with that in the CIA model. The Th17 population was decreased in the spleens of IL-27-Fc-treated CIA mice, whereas the CD4+CD25+Foxp3+ Treg population increased. In vitro studies revealed that IL-27 inhibited IL-17 production in murine CD4+ T cells, and the effect was associated with retinoic acid-related orphan receptor gammaT and signal transducer and activator of transcription 3 inhibition. In contrast, fluorescein isothiocyanate-labeled forkhead box P3 (Foxp3) and IL-10 were profoundly augmented by IL-27 treatment. Regarding the suppressive capacity of Treg cells, the proportions of CTLA-4+ (cytotoxic T-lymphocyte antigen 4), PD-1+ (programmed cell death protein 1) and GITR+ (glucocorticoid-induced tumor necrosis factor receptor) Tregs increased in the spleens of IL-27-Fc-treated CIA mice. Furthermore, in vitro differentiated Treg cells with IL-27 exerted a more suppressive capacity on T-cell proliferation. We found that IL-27 acts as a reciprocal regulator of the Th17 and Treg populations in CD4+ cells isolated from healthy human peripheral blood mononuclear cells (PBMCs), as well as from humans with rheumatoid arthritis (RA) PBMCs. Our study suggests that IL-27 has the potential to ameliorate overwhelming inflammation in patients with RA through a reciprocal regulation of Th17 and Treg cells.
Animals ; Arthritis, Experimental/*drug therapy/immunology ; Cells, Cultured ; Humans ; Interleukins/immunology/*therapeutic use ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Inbred DBA ; T-Lymphocytes, Regulatory/*immunology ; Th17 Cells/*immunology

Prediction of malignancy or invasiveness of branch duct type intraductal papillary mucinous neoplasm (Br-IPMN) is difficult, and proper treatment strategy has not been well established. The authors investigated the characteristics of Br-IPMN and explored its malignancy or invasiveness predicting factors to suggest a scoring formula for predicting pathologic results. From 1994 to 2008, 237 patients who were diagnosed as Br-IPMN at 11 tertiary referral centers in Korea were retrospectively reviewed. The patients' mean age was 63.1 +/- 9.2 yr. One hundred ninty-eight (83.5%) patients had nonmalignant IPMN (81 adenoma, 117 borderline atypia), and 39 (16.5%) had malignant IPMN (13 carcinoma in situ, 26 invasive carcinoma). Cyst size and mural nodule were malignancy determining factors by multivariate analysis. Elevated CEA, cyst size and mural nodule were factors determining invasiveness by multivariate analysis. Using the regression coefficient for significant predictors on multivariate analysis, we constructed a malignancy-predicting scoring formula: 22.4 (mural nodule [0 or 1]) + 0.5 (cyst size [mm]). In invasive IPMN, the formula was expressed as invasiveness-predicting score = 36.6 (mural nodule [0 or 1]) + 32.2 (elevated serum CEA [0 or 1]) + 0.6 (cyst size [mm]). Here we present a scoring formula for prediction of malignancy or invasiveness of Br-IPMN which can be used to determine a proper treatment strategy.
Adenocarcinoma, Mucinous/*pathology ; Adult ; Aged ; Aged, 80 and over ; Carcinoembryonic Antigen/blood ; Carcinoma, Pancreatic Ductal/*pathology ; Carcinoma, Papillary/*pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreatic Neoplasms/*pathology ; Predictive Value of Tests ; ROC Curve ; Tomography, X-Ray Computed