"It was reported that polymorphism of TNF alpha gene was present in promoter region and involves the substitution of guanine by adenosine in the uncommon (TNFA 2) allele. In this study, we investigated the significance of TNFA gene polymorphism in relation to various clinical characteristics and autoantibody profiles in SLE as well as comparing it with that of other countries, and also studied its association with peripheral TNF-a production in vitro. TNFA genotyping was performed in 126 SLE patients and 300 controls using DNA extracted from peripheral leucocytes. The biallelic polymorphism at position -308 of the TNFA promotor was determined by Ncol- RFLP. Peripheral mononuclear cell production of TNF-a was investigated by bioassay using L-929 cell cytotoxicity. The TNFA ""1 homozygote was a predominant allele (77.0%) in SLE, which was not different from the controls. TNFA ""2 homozygate was extremely rare in both patients and controls (0.8%, 1.3% respectively). The clinical manifestations between TNFA '1 and TNFA""2 did not differ. The production of autoantibodies including dsDNA, anti-La, anti-nRNP and anti-Sm was not different between two alleles, whereas anti- Ro antibody was more frequent in TNFA""1/TNFA '1 than in TNFA'1/TNFA'2 (62.1% vs 38.4%, P=0.022). The polymorphism of TNFA gene did not influence the lipopolysaccharide stimulated peripheral mononuclear cell production of TNF-a (1356+/-293 vs 1119+/-385 pg/ml; TNFA'1/TNFA'1, TNFA'1/TNFA'2 respectively). These results suggested that promoter polymorphism of TNFA was not directly involved in the susceptibility of SLE and was not responsible for differential peripheral TNF-a production, but TNFA ' may be associated with anti-Ro antibody production."
Adenosine ; Alleles ; Autoantibodies ; Biological Assay ; DNA ; Guanine ; Homozygote ; Humans ; Lupus Erythematosus, Systemic* ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; Tumor Necrosis Factor-alpha*

PURPOSE: To compare the corneal refraction, astigmatism, and corneal marking for toric intraocular lens measured with a VERION® Image Guided System and an autorefractor in order to precisely determine the toric intraocular lens target. METHODS: The medical records of 29 eyes of 29 patients were retrospectively reviewed to compare the corneal refraction, axis, and amount of astigmatism measured with a VERION® Image Guided System and an autorefractor. We compared the difference in marked axis for toric intraocular lenses as measured by a VERION Digital Marker and a manual marker. RESULTS: The average corneal refraction and amount of astigmatism were greater with the VERION® Image Guided System than with the autorefractor. The average difference in axis of astigmatism was 9.62°. The difference in axis of astigmatism in patients with more than 1.0 D of astigmatism (18 eyes) was 2.82 ± 2.27°, while that in patients with less than 1.0 D of astigmatism (11 eyes) was 20.27 ± 28.14°. The average difference in marked axis for toric intraocular lens measured by the VERION® Digital Marker and manual marker was 2.50° (0°-9.27°). CONCLUSIONS: The corneal refraction and amount of astigmatism were significantly higher with the VERION® Image Guided System, so careful concern and comparison of surgical outcomes between the two devices is needed in biometry.
Astigmatism* ; Biometry ; Humans ; Lenses, Intraocular ; Medical Records ; Retrospective Studies

No abstract available.

Isolated dislocation of all five carpometacarpal joints is extremely rare, only eleven cases had been reported since 1873. In Korea, we have not seen it probably. We experienced one case of isolated dislocation of all five carpometacarpal joints with a good result in I year after closed reduction and internal fixation.
Carpometacarpal Joints* ; Dislocations* ; Korea

No abstract available.
Spondylolysis*

No abstract available.
Ankle* ; Dislocations* ; Tendons*

Erythromelalgia (EM) is an uncommon disorder characterized by redness, heat, and painful extremities with intense burning sensation. Attacks of EM may be worsened by limb warming, exercise, or dependency of the affected extremity. Although the coexistence of EM and Raynaud's phenomenon (RP) may appear to be opposites in symptomatology and clinical presentation, recent studies provide an explanation based on a dysfunction of the regulation of vasomotor tone. Here, we report a case of EM in a patient with RP.
Burns ; Erythromelalgia ; Extremities ; Hot Temperature ; Humans ; Lupus Erythematosus, Systemic ; Sensation

Reactive perforating collagenosis(RPC) is a kind of perforating disorder characterized by the transepidermal elimination of altered dermal collagen. Two types have been recognized; the childhood or inherited form and the adult or acquired form. Acquired RPC is frequently associated with diabetes, chronic renal failure with nephropathy and liver disease. We describe a case of RPC in a 41-year-old woman of about 2 months' duration. She has had a problem of tricuspid regurgitation for 3 years. Skin lesions showed scattered umbilicated papules with central keratotic plugs, 0.3-0.8cm sized, located on the proximal extremities.
Adult ; Collagen ; Extremities ; Female ; Humans ; Kidney Failure, Chronic ; Liver Diseases ; Skin ; Tricuspid Valve Insufficiency*

Hydrocarbon poisoning is one of the most common poisonings accounting for about 3% of all poisonings in the USA. Hydrocarbons are a broad group of organic compounds consisting of hydrogen and carbon atoms. Many household products contain hydrocarbons. The primary complication of hydrocarbon poisoning results from involvement of the respiratory and the central nervous systems. Other reported complications include cardiac arrthymia, hepatocellular damage, renal failure, peripheral neuropathy, intravascular hemolysis, cutaneous injury, sudden death, and so on. We experienced two cases of acute poisoning caused by hydrocarbons: one was a 64-year-old man with cardiac arrhythmia after ingestion of gasoline and the other was a 61-year-old man with aspiration pneumonia after inhalation of combustion gas of gasoline. We report these cases and present a literature review.
Arrhythmias, Cardiac ; Carbon ; Central Nervous System ; Death, Sudden ; Eating* ; Gasoline ; Hemolysis ; Household Products ; Humans ; Hydrocarbons ; Hydrogen ; Inhalation* ; Middle Aged ; Peripheral Nervous System Diseases ; Pneumonia, Aspiration ; Poisoning ; Renal Insufficiency

PURPOSE: The rate of Cancellation of Reception (CR) in the emergency department (ED) is one scale to determine the quality of emergency care. We applied the six sigma (6sigma) method to emergency care as a quality improvement activity. 6sigma is a disciplined, data-driven approach and methodology for eliminating defects through DMAIC process (define, measure, analyze, improve, control). In fact, the 6sigma method improved process control and reduced customer dissatisfaction with business department in areas such as quality, cost, and service. We reviewed the availability of the 6sigma method for performing quality improvement activities in the ED. METHODS: We surveyed all patients who visited the ED from Oct. 6, 2001, to Oct. 12, 2001 (Measure period). We calculated the rate of CR and evaluated the causes and processes by using the 6sigma method. From Nov. 5, 2001, to Nov. 25, 2001 (Improve period), we controlled the process in the ED, educated the ED healthcare providers, and co-worked with all hospital healthcare providers to reduce the CR rate. RESULTS: During the Measure period, the mean CR rate was 8.5% (2.938 sigma level). We found that the cause of disease did not influence the CR rate. When the 6sigma method was applied, during the Improve period, the mean CR rate reduced to 6.29% (3.079 sigma level). CONCLUSION: We can implement and evaluate quality improvement activities in the ED more scientifically and systematically by applying the 6sigma method. Although it is necessary to monitor the quality of emergency care continuously, we think the 6sigma method will be a useful way to improve quality in the ED.
Commerce ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Health Personnel ; Humans ; Quality Improvement*