BACKGROUND: Clinical manifestations and complications of measles are more severe in adults than children. But, there has been few clinical and epidemiologic data about adult measles in Korea. OBJECTIVE: We investigated clinical features, laboratory findings, disease courses and complications and discussed the reason why measles incidence has been increasing recently in young adults to find out the solutions to prevent measles. METHOD: From April 1999 to February 2001, we examined prodromal symptoms, skin rash, complications, routine CBC, and blood chemistry of 42 adults who were admitted in KangBuk SamSung Hospital for measles and performed qualitative serum measles specific IgM and IgG antibody test using ELISA method. RESULTS: Age distribution of most adult measle patients was between 15 and 25 years old(78.6%). Fever was found in all patients and cough, coryza, headache, myalgia, conjunctivitis, sore throat, nausea, diarrhea, and vomit were found in decreasing order of frequency. Skin rashes were started from the face and spread to trunk, arms and then legs in 37 patients out of 42. Five patients had skin rash in the face and trunk at the same time, and one had hemorrhagic rash. Koplik's spots were found in 26 patients (62%). Among them, 2 had Koplik's spots before the rash and 24 had Koplik's spots with the rash simultaneously or thereafter. Koplik's spots were disappeared as skin rash disappeared. Exfoliative dermatitis was found following the skin rash in one patient. Among 26 patients who performed qualitiative serum measles specific IgM and IgG antibody test using ELISA, the seropositivity of measles specific IgM was 70%, of measles specific IgG was 27%, and of both measles specific IgM and IgG was 12%. Complications were like this; hepatitis in 23, cervical lympadenitis in 20, laryngitis and bronchitis in 7, otitis media in 4, pneumonia on chest X-ray in 3, hepatosplenomegaly on upper abdomen ultrasonography in 5. Two patients were in pregnancy of 12 and 16 weeks, and the former had spontaneous abortion. Pnemonia and otitis media were recovered within average 5 days after administrating antibiotics and antipyretics.
Abdomen ; Abortion, Spontaneous ; Adult* ; Age Distribution ; Anti-Bacterial Agents ; Antipyretics ; Arm ; Bronchitis ; Chemistry ; Child ; Conjunctivitis ; Cough ; Dermatitis, Exfoliative ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies* ; Exanthema ; Female ; Fever ; Headache ; Hepatitis ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Korea ; Laryngitis ; Leg ; Measles* ; Myalgia ; Nausea ; Otitis Media ; Pharyngitis ; Pneumonia ; Pregnancy ; Prodromal Symptoms ; Thorax ; Ultrasonography ; Young Adult

BACKGROUND: Clinical manifestations and complications of measles are more severe in adults than children. But, there has been few clinical and epidemiologic data about adult measles in Korea. OBJECTIVE: We investigated clinical features, laboratory findings, disease courses and complications and discussed the reason why measles incidence has been increasing recently in young adults to find out the solutions to prevent measles. METHOD: From April 1999 to February 2001, we examined prodromal symptoms, skin rash, complications, routine CBC, and blood chemistry of 42 adults who were admitted in KangBuk SamSung Hospital for measles and performed qualitative serum measles specific IgM and IgG antibody test using ELISA method. RESULTS: Age distribution of most adult measle patients was between 15 and 25 years old(78.6%). Fever was found in all patients and cough, coryza, headache, myalgia, conjunctivitis, sore throat, nausea, diarrhea, and vomit were found in decreasing order of frequency. Skin rashes were started from the face and spread to trunk, arms and then legs in 37 patients out of 42. Five patients had skin rash in the face and trunk at the same time, and one had hemorrhagic rash. Koplik's spots were found in 26 patients (62%). Among them, 2 had Koplik's spots before the rash and 24 had Koplik's spots with the rash simultaneously or thereafter. Koplik's spots were disappeared as skin rash disappeared. Exfoliative dermatitis was found following the skin rash in one patient. Among 26 patients who performed qualitiative serum measles specific IgM and IgG antibody test using ELISA, the seropositivity of measles specific IgM was 70%, of measles specific IgG was 27%, and of both measles specific IgM and IgG was 12%. Complications were like this; hepatitis in 23, cervical lympadenitis in 20, laryngitis and bronchitis in 7, otitis media in 4, pneumonia on chest X-ray in 3, hepatosplenomegaly on upper abdomen ultrasonography in 5. Two patients were in pregnancy of 12 and 16 weeks, and the former had spontaneous abortion. Pnemonia and otitis media were recovered within average 5 days after administrating antibiotics and antipyretics.
Abdomen ; Abortion, Spontaneous ; Adult* ; Age Distribution ; Anti-Bacterial Agents ; Antipyretics ; Arm ; Bronchitis ; Chemistry ; Child ; Conjunctivitis ; Cough ; Dermatitis, Exfoliative ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies* ; Exanthema ; Female ; Fever ; Headache ; Hepatitis ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Korea ; Laryngitis ; Leg ; Measles* ; Myalgia ; Nausea ; Otitis Media ; Pharyngitis ; Pneumonia ; Pregnancy ; Prodromal Symptoms ; Thorax ; Ultrasonography ; Young Adult

PURPOSE: Hepatic resection is the treatment of choice for small malignant tumor, intrahepatic cholelithiasis having normal liver function and so on. Partial hepatectomy for liver disease has been performing more commonly than the past. Postoperative mortality and morbidity are decreasing as the operative technique is developed. This report describes a review of our experience for hepatic resection and an analysis of potential risk factors affecting the morbidity and the mortality in a hepatectomy. METHODS: Between Jan. 1997 and Mar. 2001, we performed 112 cases of partial hepatectomy and retrospectively analyzed the clinicopathological features of the cases. RESULTS: The most common disease needing hepatic resection was intrahepatic duct stone (46). The mean operative time was 377 minutes. The overall in-hopital mortality and morbidity rates were 6.8% (6/112) and 25% (59/112), respectively. Various postoperative complications developed; 16 wound infections (14.2%), 6 Bile leakage (5.3%), 6 intraabdominal abscess (5.3%), 5 cardiopulmonary complications (4.4%), 2 hepatic failure (1.7%), 2 postoperative bleeding (1.7%). The old had more cardiopulmonary complications. The significant risk factors for perioperative mortality were preoperative serum bilirubin level, alkaline phosphatase, prothrombin time, partial prothrombin time, perioperative transfusion and bleeding. CONCLUSION: This paper presents risk factors of hepatectomy in our hospital. The results state importance of selection of patients and perioperative bleeding managements to reduce of morbidity and mortality of hepatectomy.
Abscess ; Alkaline Phosphatase ; Bile ; Bilirubin ; Cholelithiasis ; Hemorrhage ; Hepatectomy ; Humans ; Liver ; Liver Diseases ; Liver Failure ; Mortality ; Operative Time ; Postoperative Complications ; Prothrombin Time ; Retrospective Studies ; Risk Factors* ; Wound Infection

PURPOSE: Previous studies have outlined mechanisms by which Mycoplasma pneumonia (M. pneumonia) infection may promote allergic lung inflammation and airway remodeling, and increasing evidence from human studies suggests that atypical bacterial infections contribute to asthma exacerbation, chronic asthma, and disease severity with changes in cytokine expression. The present study evaluated changes in serum levels of vascular endothelial growth factor (VEGF) and interleukin (IL)-5 in atopic children with Mycoplasma pneumoniae pneumonia. METHODS: We recruited a total of 72 children with pneumonia. The patients were divided into 4 groups: atopic children with M. pneumonia pneumonia (group I, n=24), non-atopic children with M. pneumonia pneumonia (group II, n=23), atopic children with viral pneumonia (group III, n=13), and non-atopic children with viral pneumonia (group IV, n=12). Serum levels of IL-5, IL-13, VEGF, and tumor necrosis factor-alpha were measured at admission and at recovery using enzyme-linked immunosorbent assays. RESULTS: Serum levels of VEGF and IL-5 were elevated in group I compared with the other groups at both admission phase and clinical recovery phase. In group I, serum levels of VEGF and IL-5 were higher at recovery phase than at admission phase (VEGF: 1,102.2+/-569.4 vs. 874.9+/-589.9 pg/mL, respectively; IL-5: 150.5+/-63.9 vs. 120.2+/-46.7 pg/mL, respectively). CONCLUSIONS: The serum levels of VEGF and IL-5 were more increased in atopic children with M. pneumonia pneumonia than in the other groups. In this group, the serum levels of VEGF and IL-5 were more increased at recovery phase than at admission phase. The results of this study suggest that increases in VEGF and IL-5 may contribute to the development of hypersensitivity during M. pneumonia infection. These cytokines may act through their respective pro-inflammatory pathways to aggravate the allergic status and induce airway hypersensitivity during M. pneumonia pneumonia in atopic children.
Airway Remodeling ; Asthma ; Bacterial Infections ; Child ; Cytokines ; Humans ; Hypersensitivity ; Interleukin-13 ; Interleukin-5 ; Interleukins ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Pneumonia, Viral ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

BACKGROUND: Despite of numerous researches on the mechanisms and new therapeutic methods of chronic pain, patients are still suffering even with the help of opioids. In recent years, however, with the development of molecular-biology cell transplantation gives us a new chance for treating intractable chronic pain. The major purpose of the present study was to determine if the chromaffin cells have robust analgesic effects in the spinal atlanto-occipital subarachnoid space even without nicotine stimulation. METHODS: In order to determine whether cultured bovine adrenal medullary chromaffin cells transplanted in the spinal cord can produce analgesic effects, we purified adrenal medullary chromaffin cells and implanted them into the subarachnoid space of rats' (n = 10) spinal cord without immunosuppression, and investigated the hot sensitivity of rats' hind-paw by a light-beam test. RESULTS: It was found that compared with the control group, hot response latency of the group which received adrenal medullary chromaffin cells had increased at 14 days and the analgesic efficacy was maintained for at least 3 months. CONCLUSIONS: Adrenal medullary chromaffin cells transplanted in the rats' spinal cord may provide a permanent and locally available source of neuropeptides for the relief of intractable pain. Furthermore, these kinds of analgesic effect even produced without any stimulation such as nicotine.
Analgesics, Opioid ; Animals ; Cell Transplantation ; Chromaffin Cells* ; Chronic Pain ; Humans ; Immunosuppression ; Neuropeptides ; Nicotine ; Pain, Intractable ; Rats* ; Reaction Time ; Spinal Cord* ; Subarachnoid Space ; Transplants

BACKGROUND: Hypothermia following the induction of anesthesia is caused by core to peripheral redistribution of body heat. It has been reported that propofol causes more severe hypothermia than sevoflurane by inhibiting thermoregulatory vasoconstriction during surgical procedures. Therefore, we evaluated the induction and maintenance of anesthesia with intravenous propofol to determine if it causes more core hypothermia than inhaled sevoflurane. METHODS: Forty-five patients who underwent hysterectomy were divided into two groups randomly, a propofol-remifentanil (PR) anesthesia group and a sevoflurane-remifentanil (SR) anesthesia group. Each group was subjected to anesthetic induction with either 1.5 mg/kg propofol or inhalation of 5% sevoflurane, respectively. Anesthesia in the former group was maintained with propofol while it was maintained with sevoflurane in the latter group. Specifically, 6-10 mg/kg/hr propofol, 3 L/min medical air, 2 L/min O2, and 0.25 mg/kg/hr remifentanil were used in the PR group for maintenance, while 1.5 vol% sevoflurane, 3 L/min medical air, 2 L/min O2 and 0.25 mg/kg/hr remifentanil were used for maintenance in the SR group. We measured the core temperature 8 times, prior to induction and 10, 20, 30, 45, 60, 75 and 90 minutes after induction. RESULTS: Core temperatures decreased in both the PR and SR group during surgical operation, but there was no significant difference between the two groups. CONCLUSIONS: Anesthesia induced and maintained by propofol did not cause a greater degree of hypothermia than sevoflurane.
Anesthesia ; Hot Temperature ; Humans ; Hypothermia ; Hysterectomy ; Inhalation ; Methyl Ethers ; Piperidines ; Propofol ; Vasoconstriction

The purpose of this study was to compare the shaping ability of three Ni-Ti file systems used by dental students or the experts and consequently to aid in choosing a proper systems for educational courses of dental students and beginners. Fifty students and ten dentists who have clinical experience over two years prepared 180 simulated root canals in resin blocks with three Ni-Ti systems; ProFile(R) (PF), HeroShaper(R) (HS), K3TM (K3). After preparation, the Ni-Ti files were evaluated for distortion and canal preparation time was recorded. The images of pre- and post-instrumented canals were scanned and superimposed. Amounts of increased canal widths, deviation, and centering ratio were calculated at apical 1, 3 and 5 mm levels and statistical analysis was performed. The results were as follows: 1. HS showed the shortest preparation time and instrumented canal width in K3 was significantly larger than other groups (P < 0.05). 2. At 1 and 3 mm levels, all groups had outward deviation. In student group, at the 1 mm level, PF had the least deviation (P < 0.05). 3. In the centering ratio, the PF had the best centering ability compared to the others at 5 mm level. At 1 and 3 mm levels, HS and PF had better abilities than K3. Student group had better ratio than the expert at 3 mm level with PF (P < 0.05). Based on the results, it is surmised that the ProFile(R) is the safest and most ideal instrument for students and beginners.
Dental Pulp Cavity ; Dentists ; Humans ; Students, Dental

OBJECTIVES: This aim of this study was to effectively isolate mesenchymal stem cells (hSMSCs) from human submandibular skin tissues (termed hSMSCs) and evaluate their characteristics. These hSMSCs were then chemically induced to the neuronal lineage and analyzed for their neurogenic characteristics in vitro. MATERIALS AND METHODS: Submandibular skin tissues were harvested from four adult patients and cultured in stem cell media. Isolated hSMSCs were evaluated for their multipotency and other stem cell characteristics. These cells were differentiated into neuronal cells with a chemical induction protocol. During the neuronal induction of hSMSCs, morphological changes and the expression of neuron-specific proteins (by fluorescence-activated cell sorting [FACS]) were evaluated. RESULTS: The hSMSCs showed plate-adherence, fibroblast-like growth, expression of the stem-cell transcription factors Oct 4 and Nanog, and positive staining for mesenchymal stem cell (MSC) marker proteins (CD29, CD44, CD90, CD105, and vimentin) and a neural precursor marker (nestin). Moreover, the hSMSCs in this study were successfully differentiated into multiple mesenchymal lineages, including osteocytes, adipocytes, and chondrocytes. Neuron-like cell morphology and various neural markers were highly visible six hours after the neuronal induction of hSMSCs, but their neuron-like characteristics disappeared over time (24-48 hrs). Interestingly, when the chemical induction medium was changed to Dulbecco's Modified Eagle Medium (DMEM) supplemented with fetal bovine serum (FBS), the differentiated cells returned to their hSMSC morphology, and their cell number increased. These results indicate that chemically induced neuron-like cells should not be considered true nerve cells. CONCLUSION: Isolated hSMSCs have MSC characteristics and express a neural precursor marker, suggesting that human skin is a source of stem cells. However, the in vitro chemical neuronal induction of hSMSC does not produce long-lasting nerve cells and more studies are required before their use in nerve-tissue transplants.
Adipocytes ; Adult ; Cell Count ; Chondrocytes ; Eagles ; Flow Cytometry ; Humans ; Mesenchymal Stromal Cells ; Neurons ; Osteocytes ; Proteins ; Skin ; Stem Cells ; Transcription Factors ; Transplants

BACKGROUND AND OBJECTIVES: G protein-coupled receptors were considered to be the only natural substrates of G protein-coupled receptor kinases (GRKs). However, it was recently demonstrated that GRKs can also bind to other signal molecules. The purpose of this study was to investigate new molecules that might interact with the GRK5 using a yeast two-hybrid system to screen the cDNA library. MATERIALS AND MEDTHODS: For the yeast two-hybrid system, the "bait" was constructed to generate a LexA-GRK5 fusion protein in the EGY48 yeast strain. Rat library cDNA was inserted into the "prey". The first step in the library screening was performed by a galactose dependent leucine orthotrophism. For the second step screening, a beta-galactosidase dependent discoloration of colonies was used. Sequencing and searching of the gene bank was undertaken to characterize the clones. RESULTS: We screened a total of 1.3X10 6 clones from the cDNA library. On the first screening, 162 clones were identified by leucine orhotrophism. Another 54 clones were identified on the second screening by beta-galactosidase activation. Seven clones were selected by PCR and restriction patterns. Sequencing of seven molecules revealed that four of the clones were emerin fragments, with 2 of the remaining 3 clones being: an ID2 protein and a mitochondrial cytochrome c oxidase subunit II, with the last one remaining an unknown molecule. For the emerin fragments, their interactions with the GRK5 were confirmed by immunoprecipitation. CONCLUSION: We describe the novel protein-protein interactions of the GRK5, specifically, with three molecules. At first, these proteins may modulate the activation of the GRK5 through this specific protein-protein interaction desensitizing the beta-adrenergic receptors. Conversely, the localization of these molecules inside the cell indicates a potential new physiological role for the GRK5.
Animals ; beta-Galactosidase ; Clone Cells ; DNA, Complementary ; Electron Transport Complex IV ; Galactose ; Gene Library ; GTP-Binding Proteins ; Heart ; Immunoprecipitation ; Leucine ; Mass Screening ; Phosphotransferases* ; Polymerase Chain Reaction ; Rats ; Receptors, Adrenergic, beta ; Two-Hybrid System Techniques* ; Yeasts*

Oxygen free radical activity is elevated in diabetes mellitus and has been implicated in the etiology of vascular complications and diabetic nephropathy is a serious microvascular complication in patients with IDDM. Despite intensive investigation, the pathophysiology of diabetic renal disease has not been fully elucidated. However, several clinical and experimental studies have suggested that endothelial dysfunction and changes of peritubular microcirculation might deteriorate renal function in patients with IDDM. We performed this study to examine the oxidative stress and correlation between levels of serum creatinine and erythrocytic MDA, SOD, catalase, GPX in IDDM patients with diabetic nephropathy. Twenty one patients with IDDM(diabetic duration >5 years) and persistent albuminuria(albumin excretion>1000mg/day) and 15 normal healthy controls were investigated prospectively for erythrocytic MDA(thiobarbituric acid assay) and antioxidant enzymes[SOD(Hyland et al.), catalase(Nelson and Kiesow), GPX(Palgia and Valentine)] and correlation to serum creatinine levels. Levels of erythrocytic MDA were significantly higher in patients with diabetic nephropathy than in normal healthy controls(p<0.05) and levels of erythrocytic antioxidant enzymes were significantly lower in patients with diabetic nephropathy than in normal healthy controls(p<0.05). There was no significant correlation between serum levels of creatinine and erythrocytic MDA in group 1(r=0.12, p>0.05) and group 2(r=0.12,p>0.05) but there was significant correlation between serum levels of creatine and erythrocytic MDA in group 3(r=0.96, p<0.05). There was no significant correlation between serum levels of creatinine and erythrocytic antioxidant enzymes in all patients with diabetic nephropathy groups(group 1, group 2, and group 3; p>0.05). We concluded that increased oxidative stress and decreased antioxidative defense mechanism might be factors in the initiation of diabetic nephropathy and the oxidative stress correlated with higher serum levels of creatinine(more than 5mg/dL)(p<0.05).
Catalase ; Creatine ; Creatinine* ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies* ; Humans ; Microcirculation ; Oxidative Stress ; Oxygen ; Prospective Studies