BACKGROUND: Interleukin-5 (IL-5), IL-3, and GM-CSF are known to prolong the survival of eosinophils, and IL-5 has the most potent effect on eosinophil survivaL It is also known that divergent signals induce apoptosis in different cells. But, There have been few reports on about the intracellular signals that trigger the effectors of apoptosis. Cyclic AMP (cAMP) can modulate apoptosis in many cells. But, the role of intracellular cAMP in the IL-5 induced eosinophil survival is still not completely understood. OBJECTIVES: This study was aimed to elucidate the role of intracellular cAMP in IL-5 induced eosinophil survival. MATERIAL AND METHOD: Eosinophils were isolated from peripheral blood of atopic patients. Eosinophil viability was measured by means of propidium iodine (PI) method and the number of viable cells was counted by FAC scan (Becton Dickinson, USA). Cells were cultured with or without IL-5, and also with various cAMP-elevating agents (dibutyryl cAMP, 8-bromo-cAMP, N6- benzoyl cAMP). The concentrations of cAMP were measured by cAMP enzyme immunoassay system(BiotrakTM, Amersham). Finally cAMP dependent protein kinase A inhibitor (H8) was added to eosinophils to examine the effect of decreased intracellular cAMP activity on the viability of eosinophils stimulated with IL-5. RESULTS: The percentage of viable eosinophils was reduced rapidly from 92.1+/-1.8% to 8.23+/- 3.41% without IL-5 (p<0.05; n=ll, 4-day incubation). Upon addition of IL-5, it was increased to 33.02+7.8% (p<0.05; n=ll). In the absence of IL-5, the addition of cAMP-elevating agent increased eosinophil viability in a dose-dependent manner. Upon addition of H8 (24 uM), the eosinophil viability increased by IL-5 (52.5+/-6.4%) was significantly reduced to 27.2+/-5.4% (p<0.05;n=7). Compared with tissue culture media (TCM) only, IL-5 produced persistent elevation of intracellular cAMP of eosinophils in a time and dose dependent manner.
8-Bromo Cyclic Adenosine Monophosphate ; Apoptosis* ; Culture Media ; Cyclic AMP ; Cyclic AMP-Dependent Protein Kinases ; Eosinophils* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans ; Immunoenzyme Techniques ; Interleukin-3 ; Interleukin-5 ; Iodine ; Propidium

BACKGROUND: Facial laceration is a common clinical problem in the emergency room that is frequently associated with other craniofacial injuries. It elicits an emotional response from the patient because of the underlying concern of permanent scar and secondary facial disfigurement, so they demand prompt and adequate treatment. The aim of this study is to analyze the incidence, etiology, depth, and site of facial lacerations to provide basic data for further understanding. METHOD: This study reviewed 1,043 facial-laceration patients treated in the emergency room at Pusan Paik Hospital between March 1999 and February 2000. This retrospective study was done by reviewing and analyzing the sex and age distributions, the monthly and daily distributions, the causes of injury, the types of injury, the sites of injury, the lengths of the lacerations, and associated injuries. RESULTS: The sex ratio of men to wemen was 2.4:1, and the 0~10 age group was at the top of the age distribution. The number of patients was the highest on sundays and during March. About 9.2% of the patients visited the emergency room between 10:00 P.M. and 11:00 P.M. Falls(38.1%) were the most common cause of facial laceration, and deep laceration(51.8%) was the most common type of facial laceration. The most common laceration site was the forehead, followed by the chin and the nose. The most common associated craniofacial injury was facial bone fracture(39%). Facial-lacerations were sutured by plastic surgeons(80%), emergency physicians(10%), and oromaxillofacial surgeons(10%). We found statistical significance in the types and lengths of lacerations between men and wemen, among age groups(p<0.05). CONCLUSION: Facial laceration is one of the most common craniofacial injuries in the emergency room. By now, most lacerations have been repaired by plastic surgeons. But, the causes of lacerations are diverse and many patients are admitted due to the associated injuries. Therefore, emergency physicians should participate more aggressively in the care of facial-laceration patients to improve the outcome of the patients.
Age Distribution ; Busan ; Chin ; Cicatrix ; Emergencies* ; Emergency Service, Hospital ; Facial Bones ; Forehead ; Humans ; Incidence ; Lacerations* ; Male ; Nose ; Retrospective Studies ; Sex Ratio

BACKGROUND: Nasal hyperreactivity is a cardinal pathophysiological feature in allergic or nonallergic rhinitis. However, the mechanisms underlying nasal hyperreactivity are largely unknown. One of the proposed mechanisms is that epithelial damage may contribute to the development of nasal hyperreactivity. However, it is hard to find studies on this topic. OBJECTIVE: The aim of this study is to demonstrate whether the morphological change of nasal epithelium exists in animal model with nasal hyperreactivity or not. MATERIALS AND METHODS: Guinea pigs were sensitized in 10% TDI-ethyl acetate solution for 5 days, after which a recess of 3 weeks were allowed before exposing them in 5% TDI-ethyl acetate solution twice a week for 4 weeks. Thereafter, we observed the morphologic change of nasal mucosa with a light microscope and an electron microscope. RESULTS: Under the light microscopic observation, there were no morphological changes including epithelial damage in the TDI-provoked group. Under the electron microscopic, however, the widening of the intercellular space, the disruption of the basement membrane and the cytoplasmic vacuolization were observed. CONCLUSION: Morphological changes of the nasal epithelium were found in the animal model with nasal hyperreactivity under electron microscopic observation. Further studies to verify the relationship between the morphological changes and the nasal hyperreactivity will be needed.
Animals* ; Basement Membrane ; Cytoplasm ; Extracellular Space ; Guinea Pigs ; Microscopy, Electron ; Models, Animal* ; Nasal Mucosa* ; Rhinitis

BACKGROUND: Although several interventional pain management procedures (IPs) for reducing the acute herpes zoster (HZ)-related pain have shown some level of effectiveness on early pain relief and the prevention of postherpetic neuralgia (PHN), no conclusive evidence has been presented to support their effectiveness. OBJECTIVE: We evaluated the effectiveness of IPs during the acute phase of HZ for reducing HZ-related pain. METHODS: Sixty-one patients with acute HZ were assessed using the pain visual analogue scale (VAS) that ranges from 0 to 10 at the initial visit and after 1, 3 and 6 months. Changes in pain VAS and the incidence of PHN (pain after 1 month) were compared between 2 patient groups: those who received standard therapy with oral antivirals and analgesics (ST, n=38) and those who received standard therapy with IPs (STIPs, n=23). PHN was defined as either "pain of 1 or higher in pain VAS" or "clinically meaningful PHN (pain of 3 or higher in pain VAS)." RESULTS: Although the initial pain VAS level of patients treated with STIPs (5.74) was higher than that of patients receiving ST (4.09), no significant difference in pain VAS number was seen between the 2 groups at 3 months (0.13 vs. 0.17) and 6 months (0.09 vs. 0.03) of follow-up. The incidence of PHN also was not statistically significant different between the 2 groups at 3 (9.5% vs. 8.3%) and 6 months (9.5% vs. 4.2%). A similar trend was observed in the analysis of HZ patients whose pain VAS level was 3 or higher at the initial assessment. CONCLUSION: Standard therapy with early IPs is effective for rapidly reducing HZ-related pain.
Analgesics ; Antiviral Agents ; Follow-Up Studies ; Herpes Zoster* ; Humans ; Incidence ; Neuralgia, Postherpetic ; Pain Management*

BACKGROUND: This study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications. METHODS: We performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery. We assessed the morbidity and mortality of tracheostomy and determined the risks associated with tracheostomy complications. RESULTS: Twenty-two tracheostomy-related complications occurred in 51 patients. The morbidity and mortality rates were 35.2% (n = 18) and 0% (n = 0), respectively. Tracheostomy-related complications were tracheitis (n = 4), obstructed tracheostomy (n = 9), displaced tracheostomy (n = 5), air leakage (n = 1), stomal dehiscence (n = 1), and decannulation failure (n = 2). Most complications (19/22) occurred during the early postoperative period. Considering the risk factors for tracheostomy complications, the type of tube used was associated with the occurrence of tracheitis (p < 0.05). Additionally, body mass index and smoking status were associated with tube displacement (p < 0.05). However, no risk factors were significantly associated with obstructed tracheostomy. CONCLUSIONS: Patients with risk factors for tracheostomy complications should be carefully observed during the early postoperative period by well-trained medical staff.
Body Mass Index ; Humans ; Korea ; Medical Staff ; Mortality* ; Mouth Neoplasms ; Postoperative Period ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking ; Tracheitis ; Tracheostomy

Background: Endoscope-assisted surgery is a surgical method that has been used in oral and maxillofacial surgical fields. It provides good illumination, clear, and magnified visualization of the operative field. The purpose of this article is to describe the early clinical experiences to conduct minimally invasive surgery with endoscope-assisted enucleation of cysts on the jaw. It appears that this approach may be a superior alternative to the conventional approach. Methods: In this study, 24 patients (9 females, 15 males, average age 41.5) underwent endoscope-assisted cyst enucleation under general anesthesia. All operations were done by one surgeon. The cases were classified depending on whether bone penetration occurred at the cyst site. The cystic lesions were enucleated using an endoscope with a 0°, 1.9 mm diameter, or a 30°, 2.7 mm diameter. Two bony windows were used for the insertion of a syringe for irrigation, curettes, suction tips, sinus blades, surgical drills, and an endoscope. An additional small channel was made for the insertion of endoscopic instruments. Results: The 24 patients who underwent cyst enucleation were regularly observed for 3 to 12 months to evaluate for complications. Although some patients experienced swelling and numbness, these symptoms did not persist, and the patients soon returned to normal and there was no sign of recurrence. Conclusions The results of this study have suggested the possibility of minimally invasive surgery with endoscopes when it comes to cyst removal in the oral and maxillofacial region. Nevertheless, this study has limitations designed as a preliminary report focusing on the feasibility of endoscope-assisted cyst enucleation in the oral and maxillofacial regions.

Adult intussusception represents 1% of patients with bowel obstruction and 5% of all intussusception. It presents with a variety of acute, intermittent and chronic symptoms, thus making its preoperative diagnosis is difficult. Overall, colonic intussusception in adults is most often related to a primary carcinoma and benign smooth muscle tumors of the gastrointestinal tract are uncommon. We experienced a case of adult intussusception of the colon caused by leiomyoma. The 18-year old man was suffered from intermittent, colicky left lower quadrant pain and bloody diarrhea. Physical examination revealed a mass in the left lower abdomen. An abdominal CT scan revealed a "target mass" in the distal colon. The patient was treated with segmental resection of the descending colon and anastomosis. Pathology revealed a benign leiomyoma of the distal colon as the leading point of the colo-colic intussusception. His postoperative course was uneventful and did well.
Abdomen ; Adolescent ; Adult* ; Colon* ; Colon, Descending ; Diagnosis ; Diarrhea ; Gastrointestinal Tract ; Humans ; Intussusception* ; Leiomyoma* ; Pathology ; Physical Examination ; Smooth Muscle Tumor ; Tomography, X-Ray Computed

No abstract available.
Aged* ; Herpes Zoster* ; Humans ; Neuralgia, Postherpetic* ; Pain Management*

BACKGROUND: Once the diagnosis of operable breast cancer has been made, the single most predictive factor is lymph node status. Although patients with lymph node initially reported as histologically negative have a relatively good prognosis, the relapse rate is still considerable. In an effort to detect micrometastases in the axillary nodes, various antibodies have been used that recognize membrane and cytokeratin antigens. Cytokeratin antigens are expressed by epithelial tumors and are not expressed by normal lymphoid tissues. This study uses an immunohistochemical method to examine the incidence and the prognostic significance of such micrometastases in a series of patients with "node-negative" breast cancer. METHODS: The study population consisted of a retrospective series of 150 patient who were treated at Soonchunhyang University Hospital for breast cancer between March 1992 and February 1998. Based on the original pathologic examination, patients had negative axillary nodes. Pan-cytokeratin, a cocktail of monoclonal antibodies to cytokeratin (58 kd, 56 kd, 52 kd, 45 kd), and the avidin-biotin-peroxidase- complex technique were used to detect micrometastases in paraffin embedded lymph nodes. RESULTS: Micrometastases were detected in 16 (10.7%) patients. The recurrence rate for patients with micrometastases was 6.3% (1/16), and the recurrence rate for patients without micrometastases was 1.5% (2/134). Micrometastases correlated with the histological type (P=0.026) and were seen more frequently with larger tumor size, higher anaplastic nuclear grade, and overexpression of p53.
Antibodies ; Antibodies, Monoclonal ; Breast Neoplasms* ; Breast* ; Diagnosis ; Fibrinogen ; Humans ; Incidence ; Keratins ; Lymph Nodes* ; Lymphoid Tissue ; Membranes ; Neoplasm Micrometastasis* ; Paraffin ; Prognosis ; Recurrence ; Retrospective Studies

Xanthogranulomatous cholecystitis is a rare form of chronic gallbladder inflammation that is characterized by a severe proliferative fibrosis and has rarely been described in the radiologic literature. Like xanthogranulomatous pyelonephritis, it is an entirely benign but unusual expression of a reactive process and may be confused with a malignant neoplasm. Histologically, foamy histiocytes, multinucleated giant cells, other inflammatory cells, fibrous reaction with spindle cells, cholesterol cleft and noncaseating granuloma were found. Treatment of this benign inflammatory condition requires cholecystectomy to remove the focus of inflammation, control subsequent infection and relieve symptoms A case of xanthogranulomatous cholecystitis mimiking carcinoma of the gallbladder on abdominal USG, abdominal CT, and ERCP examination is presented with brief review of the literature.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis* ; Cholesterol ; Fibrosis ; Gallbladder ; Giant Cells ; Granuloma ; Histiocytes ; Inflammation ; Pyelonephritis, Xanthogranulomatous ; Tomography, X-Ray Computed