No abstract available.
Humans* ; Interleukin-12* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Tuberculosis, Pulmonary* ; Tumor Necrosis Factor-alpha*

Mycobacterium tuberculosis infected macrophages can become ineffective at activating CD4+ T cells through presentation of peptide antigens by MHC class II, possibly contributing to the ability of M tuberculosis to persist despite the presence of an intact immune system. Presentation of lipid antigens may help to overcome this problem. CD1 represents the key component of an MHC independent pathway for presentation nonpeptide lipid antigens to T cells. The 38 kDa glycolipoprotein antigen of M. tuberculosis is actively secreted. The antigen induces strong antibody and T-cell responses and provided partial protection against M. tuberculosis infection in mice when it is administered either entrapped in biodegradable microparticles or in the form of a DNA vaccine. But an selective anergy to stimulation with peptide of the 38 kDa was observed in the majority of tuberculosis patients. An 38 kDa antigen has been isolated by affinity chromatography using a monoclonal antibody. This antigen contains some immunosuppressive cell wall associated antigens such as lipoarabinomannan. Therefore, we purified the 38 kDa glycolipoprotein from the culture filtrate of M tuberculosis H37Rv by ammonium sulfate precipitation (55~80%), hydroxylapatite and DEAE-Sephacel column. The purified antigen showed three major bands on isoelectric focusing gel, and two-dimensional electrophoresis (2-DE) analysis of this antigen revealed five distinct spots of the 38 kDa molecular mass. One of five spots had a N-terminal sequence identical to that of the 38 kDa glycolipoprotein (pstS-1). Other protein spots could not determine sequences. An antiserum against the recombinant 38 kDa antigen of M tuberculosis reacted strongly with the purified the 38 kDa antigen.
Ammonium Sulfate ; Animals ; Cell Wall ; Chromatography, Affinity ; DNA ; Durapatite ; Electrophoresis ; Humans ; Immune System ; Isoelectric Focusing ; Macrophages ; Mice ; Mycobacterium tuberculosis* ; Mycobacterium* ; T-Lymphocytes ; Tuberculosis

In order to observe the changes in left ventricular function during coronary artery occlusion and reperfusion, left anterior descending (LAD) coronary arteries in the anesthetized dogs were occluded for 1 hour and then reperfused for 4 hours. Hemodynamic indexes of global systolic and diastolic function and regional wall thickness changes as a regional contractile index were measured during occlusion and reperfusion. The results were as follows; 1) Indexes of global systolic function (left ventricular peak systolic pressure, peak positive dP/dt) and global diastolic function (peak negative dP/dt, time constant, left ventricular end-diastolic pressure) showed deterioration in early occlusion period (10-30 minutes) but gradually improved even if coronary occlusion persisted. Reperfusion did not induce significant changes except that peak positive dP/dt transiently deteriorated 30 minutes after reperfusion and left ventricular end-diastolic pressure decreased 1.5-2 hours after reperfusion. 2) Indexed of regional function (i.e, end-diastolic thickness and % systolic thickening of anterior left ventricular wall) deteriorated by 10 minutes' occlusion which persisted during the entire occlusion period. Reperfusion induced no significant improvement in regional contractile function compared with occlusion 60 minutes' data, which suggested reperfusion for 4 hours after 1 hour's LAD occlusion may be insufficient for the ischemic region to recover its contractility. 3) Reperfusion arrhythmia (ventricular tachycardia) was noted in most (6/9) of the dogs, one of which deteriorated into ventricular fibrillation and the others spontaneously converted to normal sinus rhythm.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Hemodynamics ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Function, Left*

No abstract available.
Humans ; Listeria* ; Meningitis, Listeria*

No Abstract Available.
Humans ; Interleukin-12* ; Interleukin-18* ; Tuberculosis, Pleural*

Major known causes of neonatal adrenal insufficiency are prolonged maternalsteroid use, adrenal hemorrhage from the perinatal stress and adrenogenital syndrome. Theoretically adrenal aplasia might be a cause of neonatal adrenal insufficiency but it has not been reported yet. We had experienced a case of adrenal aplasia in a 5 day-old male neonate whose chief complaint was hyperpigmentation. His laboratory findings were compatible with adrenal insufficiency and adrenal gland was not detected by the ultrasonography and thin section abdominal CT. We reported a case of adrenal aplasia with a brief review of the related literature.
Adrenal Glands ; Adrenal Insufficiency ; Adrenogenital Syndrome ; Hemorrhage ; Humans ; Hyperpigmentation ; Infant, Newborn ; Male ; Tomography, X-Ray Computed ; Ultrasonography

Infected urachal cyst is a rare disorder. While a urachal cyst is usually asymptomatic, the infected cyst may mimic a variety of acute intraabdominal infection. We have experienced a case of infected urachal cyst in a 3 year old boy complaining of high fever and diarrhea. During hospitalization, symptoms and sings of acute peritonitis dominated the clinical feature. Abdominal sonogram, abdominal computerized tomography and cavitogram demonstrated cystic mass posterior to central abdominal wall. Pus was drained from the cystic lesion by ultrasound-guided needle aspiration and indwelling catheter insertion. E.coli was cultured from pus. In the differential diagnosis of acute abdomen ultrasonographic examination of abdomen should be recruited to rule out the infected urachal cyst.
Abdomen ; Abdomen, Acute ; Abdominal Wall ; Catheters, Indwelling ; Child, Preschool ; Diagnosis, Differential ; Diarrhea ; Fever ; Hospitalization ; Humans ; Intraabdominal Infections ; Male ; Needles ; Peritonitis* ; Suppuration ; Urachal Cyst*

PURPOSE: To describe the usefulness of small bowel enteroclysis using a hemodialysis blood pump. MATERIALS AND METHODS: Over a 16 month period, 135 double contrast small bowel enteroclysis examinations were performed in132 patients using a hemodialysis blood pump. Following intubation of the proximal jejunum, barium at a dilutionof 50% and 0.5% methylcellulose were infused at a constant rate using a hemodialysis blood pump and multiple spotfilms of the small intestine were obtained. Success rate, quality of radiographs, positive findings, fluoroscopitime and complications were evaluated. RESULTS: Only two of 135 examinations (1.5%) failed due to lack ofcooperation by the patient. Rates of good distensability were 97.6% in the proximal portion, 91.2% in the minportion and 52% in the distal portion and rates of good transparency were 96%, 84% and 56% respectively.Transparency and distensability of the small intestine were better in proximal than distal small bowel. Theradiographs showed positive findings in 25% of cases. The mean fluoroscopic time was 21 min, 10 sec(8min,22sec-57min, 30sec). No major complication was found during or after exam ination. CONCLUSION: It spite of thelong fluoroscopic time and invasiveness, double contrast small bowel enteroclysis is useful for the evaluation ofsmall bowel disease. The infusion of barium and methylcellulose using a hemodialysis blood pump give radiographsof good quality.
Barium ; Humans ; Intestine, Small ; Intubation ; Jejunum ; Methylcellulose ; Renal Dialysis*

PURPOSE: This study was undertaken to develop directions for research on nursing practice education and also for standardization of contents of Fundamental Nursing Practice (FNP) by identifying and analyzing the present content and inconsistency in FNP textbooks. METHOD: Eleven FNP textbooks published between 2007 and 2013 were selected and itemized nursing contents were compared and analyzed. Nursing professors and practicingnurses prioritized contents identified from an actual condition survey based on theoretical reason and clinical guides for each item. RESULTS: Inconsistencies were found for 34 domains with 219 sub items and of them, 21 domains and 84 items needed to be standardized. Number of items that showed consistency between professors and nurses (ICC > or = .800) was 29 (34.5%) and for complete consistency (ICC=1), 4 (4.8%). Number of items that showed inconsistency between the groups (ICC< .600) was 30 (35.7%) and very low consistency (ICC=0), 10 (11.9%). CONCLUSION: The results indicate a difference between understood validity of content by professors and by nurses and technical differences among FNP textbooks. Therefore confirmation of the items needing to be standardized and differences in understanding content by professors and by nurses shows a need for standardization of practice education between course and clinical practice. These results provide basic data for developing standardized form of FNP education.
Education* ; Education, Nursing ; Nursing*

Heat stroke occurs when body thermal regulation is upset and unable to dissipate adequate amounts of heat with rise in body temperature. Thus heat stroke may result in rhabdomyolysis and multiorgan failure. We observed two childhood cases of heat stroke with rhabdomyolysis and multiorgan failure. One case was caused by accidentally being left in a car trunk for 3 hours on a sunny afternoon in late spring and the other case occurred climbing a mountain on a hot summer day during a school trip for improving individual self-control. The first case, a boy almost 5 years old, displayed thetypical clinical features of heat stroke including hyperpyrexia, CNS disturbance, hot dry skin, acute liver failure, rhabdomyolysis, oligo- anuric acute renal failure, and disseminated intravascular coagulopathy. He was treated with general supportive care and daily hemodialysis. Despite the aggressive management, he died of shock on the sixteenth day of admission day. The second case, a 14-year-old middle school boy, displayed similiar features of the first case but showed milder symptoms. He was also treated with general supportive care and daily hemodialysis for 10 days. He recovered completely and was discharged in good condition. The public including medical and paramedical personnels should be warned of the dangers of childhood heat stroke, which is potentially lethal, but preventable.
Acute Kidney Injury ; Adolescent ; Allied Health Personnel ; Body Temperature ; Child ; Child, Preschool ; Heat Stroke* ; Hot Temperature* ; Humans ; Liver Failure, Acute ; Male ; Renal Dialysis ; Rhabdomyolysis* ; Shock ; Skin