The hyperimmunoglobulinemia E (Jobs) syndrome (HIES) is characterized by marked elevated levels of IgE, recurrent cutaneous and systemic staphylococcal infections, atopic-like dermatitis, and defective neutrophil chemotaxis. Three cases of HIES have been reported in Korea, but not in the dermatology literature. We report a case of HIES with cutaneous infections and MRSA (methicillin-resistant Staphylococcus aureus). A 15-month-old girl presented with intractable pruritic excoriated papular pustular skin lesions and multiple subcutaneous abscesses. Surgical drainage of the abscesses and a course of antibiotic treatment in addition to topical steroids for about 7 weeks resulted in a remarkable improvement.
Abscess ; Chemotaxis ; Dermatitis ; Dermatology ; Drainage ; Female ; Humans ; Hypergammaglobulinemia* ; Immunoglobulin E ; Infant ; Job Syndrome* ; Korea ; Methicillin-Resistant Staphylococcus aureus ; Neutrophils ; Skin ; Staphylococcal Infections ; Staphylococcus ; Steroids

No abstract available.
Lichens* ; Mucinosis, Follicular*

Phytosphingosine-1-phosphate (PhS1P) was found to stimulate an intracellular calcium increase via phospholipase C but not pertussis toxin (PTX)- sensitive G-proteins in L2071 mouse fibroblasts. PhS1P also activated ERK and p38 kinase, and these activations by PhS1P were inhibited by PTX. Moreover, PhS1P stimulated the chemotactic migration of L2071 cells via PTX-sensitive Gi protein(s). In addition, the PhS1P-induced chemotactic migration of L2071 cells was also dramatically inhibited by LY294002 and SB203580 (inhibitors of phosphoinositide 3-kinase and p38 kinase, respectively). L2071 cells are known to express four S1P receptors, i.e., S1P1, S1P2, S1P3, and S1P4, and pretreatment with an S1P1 and S1P3 antagonist (VPC 23019) did not affect on PhS1P-induced chemotaxis. This study demonstrates that PhS1P stimulates at least two different signaling cascades, one is a PTX-insensitive but phospholipase C dependent intracellular calcium increase, and the other is a PTX-sensitive chemotactic migration mediated by phosphoinositide 3-kinase and p38 kinase.
1-Phosphatidylinositol 3-Kinase/metabolism ; Animals ; Calcium Signaling/drug effects ; Chemotaxis/*drug effects ; Estrenes/pharmacology ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Fibroblasts/*cytology/*drug effects ; GTP-Binding Proteins/*metabolism ; Gene Expression Regulation/drug effects ; Humans ; Mice ; Pertussis Toxin/*pharmacology ; Phosphorylation/drug effects ; Pyrrolidinones/pharmacology ; RNA, Messenger/genetics/metabolism ; Receptors, Lysosphingolipid/genetics/metabolism ; Sphingosine/*analogs & derivatives/pharmacology ; p38 Mitogen-Activated Protein Kinases/metabolism

Akt, heat shock protein (HSP72)72, and HSP90 induced by ischemic preconditioning protect cells from the ischemic injury. The purpose of this study was to examine the alterations of the level of phospho-Akt, HSP72, and HSP90 in the rat tibialis anterior and soleus muscles after cyclic episodes of ischemic preconditioning. Sprague-Dawley rats aged 35 weeks were divided into control and ischemic preconditioning (IP) groups. The IP group was divided into 3 subgroups based on cycles of IP. Left common iliac artery was occluded 3, 6, and 10 times for 5 minutes, followed by 5 minutes reperfusion. The experimental animals were sacrificed at 0, 3, 6, 24, and 72 hours after reperfusion, and left tibialis anterior and soleus muscles were removed. The expression of phospho-Akt, HSP72, and HSP90 were examined with immunohistochemical methods and Western blot analysis. The results were as follows; 1. In the 3 and 6 times of IP groups, the expression of phospho-Akt (p-Akt) was increased at 0 and 3 hours after reperfusion, compared with control group. The expression of p-Akt in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 72 hours after reperfusion, the expression of p-Akt showed no difference among the IP groups. The expression of p-Akt was higher in Soleus than that in Tibialis anterior. 2. The expression of HSP72 in 3 times of IP group increased at 0 and 3 hours after reperfusion, compared with 6 and 10 times of IP groups. The expression of HSP72 in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 72 hours after reperfusion, the expression of HSP72 showed no difference among the IP groups. The expression of HSP72 was higher in Soleus than that in Tibialis anterior. 3. In the 3 and 6 times of IP groups, the expression of HSP90 increased at 0 and 3 hours after reperfusion, compared with control group. The expression of HSP90 in the 10 times of IP group was lower than that in 3 and 6 times of IP groups. At 24 hours after reperfusion, the expression of HSP90 showed no difference with increasing episode of IP. The expression level of HSP90 was higher in Soleus than that in Tibialis anterior. These findings suggest that ischemic preconditioning increases the expression of p-Akt, HSP72 and HSP90 at early phase after reperfusion in the rat tibialis anterior and soleus muscles. However, increased cycles of ischemic preconditioning may not induce the expression of them.
Animals ; Blotting, Western ; Heat-Shock Proteins ; Iliac Artery ; Ischemic Preconditioning* ; Muscles* ; Phosphorylation* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

Purpose: To analyze the clinical and radiographic results of patients who underwent total knee arthroplasty with a posterior cruciate retaining medial pivot knee, and to identify the technical aspects in preserving the posterior cruciate ligament. Materials and Methods: From March 2002 to Dec 2003, 40 total knee arthroplasties with a cruciate retaining medial pivot knee were implanted in 28 cases. The average follow-up period was 2.8 years (range, 2 to 3.7 years). The clinical and radiographic results were evaluated using the clinical and roentgenographic evaluation and scoring system of the American Knee Society. Results: The average flexion contracture before surgery was 5.4degrees, which improved to 0.6degrees at the last follow-up. The average preoperative knee flexion was 126.1degrees and 126.6degrees at the last follow-up. The average knee score improved from 60 points preoperatively to 94.8 points postoperatively, and the average functional score improved from 55.3 points to 87.0 points at the final evaluation. The average post operative alpha, beta, gamma and delta angles were 95.1degrees, 91.1degrees, 3.6degrees and 84.0degrees, respectively. There were no postoperative complications. Conclusion: The short term clinical results in patients who had undergone total knee arthroplasty with a cruciate retaining medial pivot knee was acceptable.
Arthroplasty ; Contracture ; Follow-Up Studies ; Humans ; Knee* ; Posterior Cruciate Ligament ; Postoperative Complications

PURPOSE: The purpose of this study was to analyze the accuracy of the mechanical axis and implant positions postoperatively and to evaluate the radiology results of computer assisted navigation surgery for bone cutting and ligament balancing in revision TKA. MATERIALS AND METHODS: 13 consecutive revision TKAs were performed by a single surgeon with use of computer assisted surgery (CAS) from July 2004 to August 2005. At the revision, the mean age was 64.7 years. The mean interval from the index arthroplasty was 9.8 years. The cause of the revision included 11 cases of polyethylene wear and 2 cases of loosening. Two observers measured the mechanical axis, position of the implants, and level of joint lines. RESULTS: By observer I, the mechanical axis improved from varus 11.9degrees to valgus 1.5degrees, and the mean alpha, bets, gamma and delta angles were 95.3, 90.8, 3.9 and 87.6degrees respectively. From observer II, the mechanical axis improved from varus 11.6degrees to valgus 1.6degrees, and mean alpha, beta, gamma and delta angles were 95.5, 90.5, 4.1 and 87.9degrees respectively. The measured angles from observers I and II showed a good correlation. CONCLUSION: Accurate bone cutting and verification in each step are possible using real time information provided by the CAS. The mechanical axis, component positions, joint line could be checked and adjusted with feedback of navigation system. Information about flexion and extension gap and ligament balancing could be verified during revision surgery.
Arthroplasty* ; Axis, Cervical Vertebra ; Joints ; Knee* ; Ligaments ; Polyethylene ; Surgery, Computer-Assisted*

PURPOSE: The purpose of this research was to compare the intra-operative and post-operative measured angle in total knee arthroplasty (TKA) and to evaluate the postoperative improvement in the mechanical axis. MATERIALS AND METHODS: Forty TKAs were performed using CAOS between February and May 2004. We measured the mechanical axis in the preoperative orthograms. After inserting the implant, we measured the femoral component angle (FCA), tibial component angle (TCA) and tibial component slope (TCS) using the verification tool in CAOS, on the post-operative orthogram and X-ray of the lateral tibial view, 2 observers measured the FCA, TCA, TCS and mechanical axis. RESULTS: The mean FCA, TCA and TCS using the verification tool in CAOS, were valgus 0.03+/-0.85degrees, valgus 0.49+/-1.02degrees, nd 4.26+/-1.64degrees. The mean FCA, TCA and TCS by observer 1 were valgus 0.67+/-1.24degrees, varus 0.54+/-1.54degrees, and 4.57+/-1.74degrees and those by observer 2 were valgus 0.48+/-1.17degrees, varus 0.52+/-1.44degrees, and 4.24+/-2.83degrees. There was a positive correlation between the measured angle by respective observers and the angle measured by the CAOS (p<0.05). The mechanical axis by observers 1 and 2 improved from varus 13.96degrees to valgus 0.04degrees and from varus 14.12degrees to valgus 0.08degrees respectively. CONCLUSION: CAOS affords the possibility of precisely placing the femoral and tibial components. The angles measured by the respective observers and in the CAOS were significantly correlated.
Arthroplasty* ; Axis, Cervical Vertebra ; Knee*

No abstract available.
Lymph Nodes* ; Tuberculosis*

OBJECTIVE: To test if the intake of H2 receptor antagonists (H2-RAs) increases the risk of gastric cancer in the elderly. METHODS: The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1993. The information on H2-RAs exposure was obtained from a drug prescription database compiled between Jan. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. RESULTS: After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 (95% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). CONCLUSION: The intake of H2-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.
Achlorhydria ; Aged* ; Body Mass Index ; Busan ; Case-Control Studies* ; Cimetidine ; Cohort Studies ; Drug Prescriptions ; Famotidine ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Logistic Models ; Odds Ratio ; Parturition ; Pharmacoepidemiology ; Postal Service ; Surveys and Questionnaires ; Ranitidine ; Stomach Neoplasms* ; Stomach Ulcer

BACKGROUND: Few studies have examined the association between mercury exposure and obesity. The aim of this study is to investigate the association between blood mercury concentrations and indices of obesity in adults. METHODS: A total of 200 healthy subjects, aged 30 to 64 years, who had no history of cardiovascular or malignant disease, were examined. Anthropometric and various biochemical profiles were measured. Visceral adipose tissue (VAT) was measured using dual-energy X-ray absorptiometry (DXA). RESULTS: All subjects were divided into three groups according to blood mercury concentrations. Compared with the subjects in the lowest tertile of mercury, those in the highest tertile were more likely to be male; were current alcohol drinkers and smokers; had a higher body mass index (BMI), waist circumference (WC), and VAT; had higher levels of blood pressure, fasting glucose, and insulin resistance; and consumed more fish. The blood mercury concentration was significantly associated with anthropometric parameters, showing relationships with BMI, WC, and VAT. After adjusting for multiple risk factors, the odds ratios (ORs) for high mercury concentration was significantly higher in the highest VAT tertile than in the lowest VAT tertile (OR, 2.66; 95% confidence interval, 1.05 to 6.62; P<0.05). CONCLUSION: The blood mercury concentration was significantly associated with VAT in healthy adults. Further studies are warranted to confirm our findings.
Absorptiometry, Photon ; Adiposity* ; Adult* ; Blood Pressure ; Body Mass Index ; Fasting ; Glucose ; Healthy Volunteers ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Male ; Obesity ; Odds Ratio ; Risk Factors ; Waist Circumference