To investigate the imbalance of the cytokine production profile of T cells from atopic asthmatics, we measured concentrations of IL-4, IL-5 and IFN-y by ELISA method in the culture supernatants of peripheral blood mononuclear cells(PBMCs) and Derrnato-phagoides pteronyssinus(Der p) J-stimulated PBMCs from Der p-sensitized atopic asthmatics, Der p-sensitized healthy atopits, non-atopic asthmatics and healthy non-atopics. The suppressive effect of IFN-y on cytokine production of Der p J-stimulated PBMCs was also examined. The PBMCs from atopics showed higher IL-4 and IL-5 production in response to PHA +TPA and higher IFN-gamma production in response to Der p Jq compared with non-atopits. The Der p J-stimulated PBMCs from atopics showed a tendency of increased IL-5 production in response to Der p J and higher IL-4 and IL-5 production in response to PHA+TPA compared with non-atopics. IL-5 production of Der p J-stimulated PBMCs from atopics was suppressed by IFN It is suggested that an imbalance in IL-4, IL-5 and IFN-y production is a feature of the atopic state. The TH2 characteristics of allergen-stimulated PBMCs could be regulated by IFN-y.
Enzyme-Linked Immunosorbent Assay ; Interleukin-4 ; Interleukin-5 ; T-Lymphocytes

No abstract available.

We report herein an unusual case of tick bite. A 56 year old woman complained of erythematous nodular skin lesion on the left upper chest. An excision biopsy specimen of the lesion showed darkish-red nodule, in which there was a tick. It was identified as an adult female of Ixodes nipponensis by the scanning electron microscopic examination.
Adult ; Biopsy ; Female ; Humans ; Ixodes* ; Middle Aged ; Skin ; Thoracic Wall* ; Thorax* ; Tick Bites ; Tick Infestations* ; Ticks*

Using Mercox CL-2B, intravascular casting was performed follwoing intracameral injection with 2.0microgram/microliter of Endothelin-1(ET-1) in the rabbit eye. One hour after intracameral injection with ET-1 caused severe focal andsegmental constriction of major arterial circle(MAC). Obstruction of the small branch of MAC caused localized filling defect and decreased number of capillaries in the vascular cast. The diameters of vascular cast were reduced at about 22.2% in proximal MAC, 22.4% in distal MAC and 21.8% in first branch of MAC. This results were suggested that ET-1 may play a role in the regulation of blood flow in the anterior segment vasculature of the rabbit.
Capillaries ; Constriction ; Endothelin-1* ; Microvessels*

No abstract available.
Hysterectomy*

PURPOSE: Hypothermia adversely affects the coagulation that could be of clinical significance in patients receiving clopidogrel. We evaluated the influence of hypothermia on transfusion requirements in patients undergoing isolated off-pump coronary artery bypass surgery (OPCAB) who continued clopidogrel use within 5 days of surgery. MATERIALS AND METHODS: Protocol-based, prospectively entered data of 369 patients were retrospectively reviewed. The time-weighted average of intraoperative temperatures and the temperature upon ICU admission (TWA-temp) was assessed. Patients were divided into normothermia (> or =36degrees C, n=224) and hypothermia (<36degrees C, n=145) group. The transfusion requirement for perioperative blood loss was assessed and compared. RESULTS: Patients with hypothermia were older and had lower body surface area (BSA) than patients with normothermia. Age and BSA adjusted transfusion requirement was significantly larger in the hypothermia group [patients requiring transfusion: 64% versus 48%, p=0.003; number of units: 0 (0-2) units versus 2 (0-3) units, p=0.002]. In multivariate analysis of predictors of perioperative multiple transfusion requirements, hypothermia was identified as an independent risk factor along with age, female gender, BSA, chronic kidney disease, and congestive heart failure. CONCLUSION: Hypothermia was associated with increased transfusion requirement in patients undergoing OPCAB who received clopidogrel in proximity to surgery. Considering the high prevalence and the possibility of hypothermia being a modifiable risk factor, aggressive measures should be undertaken to maintain normothermia in those patients.
Aged ; Coronary Artery Bypass, Off-Pump/*methods ; Female ; Humans ; Hypothermia/*physiopathology ; Male ; Middle Aged ; Retrospective Studies ; Ticlopidine/*analogs & derivatives/therapeutic use

Background: To examine whether glycated hemoglobin (HbA1c) test would be a suitable screening tool for detecting high-risk subjects for diabetes compared to oral glucose tolerance test (OGTT) according to accompanied central obesity. Methods: In this prospective population-based cohort study, both OGTT and HbA1c tests were performed and continued every 2 years up to 12 years among individuals with non-diabetic state at baseline (aged 40 to 69 years, n=7,512). Incident diabetes was established by a doctor, HbA1c ≥6.5%, and/or fasting plasma glucose (FPG) ≥126 mg/dL, and/or 2-hour postprandial glucose (2hPG) level based on OGTT ≥200 mg/dL. Discriminative capacities of high HbA1c (≥5.7%) versus high 2hPG (≥140 mg/dL) for predicting incident diabetes were compared using Cox-proportional hazard regression and C-index. Results: During the median 11.5 years of follow-up period, 1,341 (17.6%) developed diabetes corresponding to an incidence of 22.1 per 1,000 person-years. Isolated high 2hPG was associated with higher risk for incident diabetes (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.56 to 5.17) than isolated high HbA1c (HR, 2.79; 95% CI, 2.40 to 3.26; P<0.05). In addition, high 2hPG provided better discriminatory capacity than high HbA1c (C-index 0.79 vs. 0.75, P<0.05). Meanwhile, in subjects with central obesity, the HR (3.95 [95% CI, 3.01 to 5.18] vs. 2.82 [95% CI, 2.30 to 3.46]) and discriminatory capacity of incident diabetes (C-index 0.75 vs. 0.75) between two subgroups became comparable. Conclusion Even though the overall inferior predictive capacity of HbA1c test than OGTT, HbA1c test might plays a complementary role in identifying high risk for diabetes especially in subjects with central obesity with increased sensitivity.

PURPOSE: Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. MATERIALS AND METHODS: Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. RESULTS: With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). CONCLUSION: Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.
Chemoradiotherapy* ; Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Pancreatic Neoplasms* ; Survival Rate

PURPOSE: Prognosis of papillary thyroid carcinoma (PTC) is very favorable, but PTC frequently invade adjacent soft tissue and metastases to cervical lymph node. We evaluated the pattern of cervical neck lymph node metastasis in PTC according to tumor size. METHODS: From August 2005 to January 2009, 353 patients were underwent surgery for PTC. Among these patients, total thyroidectomy with cervical neck lymph node dissection were done in 266 patients. We subdivided patients into four groups according to size and compared the clinicopathologic characters between groups. And we confirmed the factors affecting central neck node metastasis. RESULTS: The mean age of patients of diagnosis was 49.1 years and female to male ratio was 5.8:1. Cervical lymph node metastasis were in 47.0% of the total cases. Cervical lymph node metastases and invasion to adjacent structure increased with tumor size. But, there were no significant differences in tumor size, invasion to adjacent structure, multifocality or bilaterality according to cervical lymph node metastasis. Early diagnostic age and sexuality were significantly related to cervical lymph node metastasis of PTC. CONCLUSION: PTC showed the aggressiveness with increasing tumor size. Tumor size was not related to cervical lymph node metastasis. These findings suggest that tumor size can help treat PTC, can`t be used by prediction factor of cervical lymph node metastasis.
Diagnosis ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Male ; Neck* ; Neoplasm Metastasis* ; Prognosis ; Sexuality ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is one of the well known complication of conttolled ovarian hyperstimulation. Though there have been numerous protocols for the prevention of OHSS, it has not been completely preventable until now. This study was performed to identify clinical predictors for early and late OHSS. METHODS: A retrospective analysis of all IVF cycles in 1993 up to June 1996 was performed. OHSS was diagnosed using the criteria of Rabau modified by Schenker. All cases of OHSS reported in this study presented with marked ovarian enlargement, ascites, oliguria, hemoconcentration and electrolyte disturbance. Ovarian stimulation was carried out using a combination of gonadotrophin releasing hormone-agonist, follicle-stimulation hormone and human menopausal gonadotrophin. 27 patients has moderate or severe OHSS presenting 3-7 days post-human chorionic gonadotrophin (hCG), and 21 patients had severe OHSS presenting 12-17 days post-hCG. RESULTS: No patient with early OHSS went onto develop late OHSS, and no patient with late OHSS had demonstrated early OHSS. Logistic regression showed that early OHSS was predicted by the number of oocytes retrieved and the estradiol concentration on the day hCG injection (P<0.05). Late OHSS was predicted by the transferred embryos, B-hCG on 14 day after hCG injection (P<0.05). CONCLUSION: Early OHSS was an acute effect of the hCG administered prior to egg retrieval in women with high estradiol and large number of retrieved oocytes. Our analysis of the risk factors for early OHSS indicates that cryopreservation of all embryos will not alter the risk of early OHSS even though it should prevent late OHSS. Late OHSS was induced by the rising serum concentration of hCG produced by the early pregnancy, the number of transferred embryos must be adjusted carefully, since it was associated with multiple gestation.
Ascites ; Chorion ; Cryopreservation ; Embryonic Structures ; Estradiol ; Female ; Humans ; Logistic Models ; Oliguria ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Ovum ; Pregnancy ; Retrospective Studies ; Risk Factors