We report a case of unilateral nevoid telangiectasia associated with acanthosis nigricans in a 20-year old male patient. Unilateral nevoid telangiectasia may be congenital or acquired. The unilateral and dermatomal distribution suggests that distribution of target vessels is fixed and that they are sensitive to estrogen. Estrogens are mainly produced by the ovaries, but they are also produced by peripheral cirornatization of androgen. Because a major site of this conversion is adipose tissue, estrogen can increase in an obese person. Obesity also reverses the metabolism of estrogen and increases the serum insulin level. Therefore it seems that obesity in our patient induces the development of unilateral nevoid telangiectasia and acanthosis nigricans.
Acanthosis Nigricans* ; Adipose Tissue ; Estrogens ; Female ; Humans ; Insulin ; Male ; Metabolism ; Obesity ; Ovary ; Telangiectasis* ; Young Adult

PURPOSE: Human umbilical cord blood as a potential source of hematopoietic stem cell for stem cell transplantation in children has recently been advocated. Clinical application of cord blood transplantation, however, requires adequate blood volume and number of stem cells. Currently, the number of stem cells in the cord blood is usually measured by flowcytometry, which requires strict quality control and high costs. Here, we postulate that the number of nucleated red blood cells(NRBC) which are relatively immature erythroid cells may correlate well with that of CD34-expressing(CD34+) cells which are considered lymphohematopoietic precursors. If so, CD34+ cell-rich cord blood can be selected and such cells enumerated by a simple and cost-effective blood smears. METHODS: Correlation between CD34+ cell and nucleated RBC in human cord blood were checked. Sixty cord blood specimens(30 specimens for group A with NRBC>500/mul and 30 specimens for group B with NRBC<500/mul) from healthy newborns were collected in EDTA bottles and transported to our laboratory at room temperature. CD34+ cells were counted by flowcytometry(FACScanTM: Becton Dickinson) within 72 hours after collection, and NRBC by light microscopy. The results were as following. RESULTS: 1.The proportion of CD34+ cells in umbilical cord blood was, in the average, 0.85%(+/-1.1) of mononuclear cells. 2.There was a significant difference between the means of CD34+ cell counts in group A(NRBC<500/ul; 30+/-48(SD)) and in group B(NRBC>500/ul; 55+/-61(SD))(p<0.005). 3.Regression relationship among CD34+ cell, WBC, and NRBC counts was as following. ln(CD34+ cell) = -12.21 + 1.46xln(WBC)+ 0.25xln(NRBC) gamma2=30.07 p=0.0001 4.There was a significant correlation between CD34+ cell counts and NRBC counts(gamma=0.4334, p<0.005) CONCLUSIONS: Our results suggest that there is a significant correlation between CD34+ cell counts and NRBC counts, and that CD34+ cell-rich cord blood specimens can be selected by a simple NRBC counting.
Blood Volume ; Cell Count ; Child ; Cord Blood Stem Cell Transplantation ; Edetic Acid ; Erythroid Cells ; Fetal Blood* ; Hematopoietic Stem Cells ; Humans* ; Infant, Newborn ; Microscopy ; Quality Control ; Stem Cell Transplantation ; Stem Cells

BACKGROUND: The type of the infiltrating cells in alveolitis may be determined by the chemokines in the lesion. MIP-1alpha, a C-C type chemokine, stimulates proliferation and cytokine secretion from macrophages and induces early neutrophilic and later monocytic inflammation in vivo. IL-8, a C-X-C type chemokine is known to attract neutrophils and T-lymphocytes. This study is performed to find out the relative role of two different chemokines in diffuse interstitial lung disease. SUBJECT AND METHOD: We measured the secretion of MIP-1alpha and IL-8 from alveolar macrophages(AM), and their level in BAL fluid of 26 patients with DILD (10 IPF, 4 collagen disease, 10 sarcoidosis, and 2 hypersensitivity pneumonitis) and 7 normal control. RESULT: IL-8 secretion was significantly increased in patients with DILD (8.15+/-4.58 ng/ml) than in normal (1.10+/-0.93 ng/ml, p=0.0003). Significant correlation was found between IL-8 secretion and total cell number in BAL fluid (r=0.484, p=0.0068), %(r=0.592, p=0.0004) and No. (r=0.516, p=0.0042) of lymphocyte, and % of AM (r=-0.505, 0.0032). MIP-1alpha secretion was also increased in DILD (2.41+/-1.45 ng/ml) compared to control (0.63+/-0.30 ng/ml, p=0.0031), and showed a tendency of correlation with total cell number (r=0.368, p=0.0456) and No. of alveolar macrophages (r=0.356, p=0.0579) in BAL fluid. The concentration of IL-8 in BAL fluid was significantly increased in the patients with DILD (40.4+/-34.5 pg/ml) compared to control (3.90 +/- 2.47 pg/ml, p=0.0094) and it showed a significant correlation with the total cell number(r=0.484, p=0.0068), %(r=-0.505, p=0.0032) of AM, and % (r=0.592, p=0.0004) and No. (r=0.516, p=0.0042) of lymphocyte in BAL fluid. But there was a no significant difference in MIP-1alpha concentration in BAL fluid between normal control group and the patients with DILD. Conclusion: From the above results, we concluded that AM of DILD releases increased amount of both IL-8 and MIP-1alpha but IL-8 has better correlation with the type of alveolitis.
Cell Count ; Chemokine CCL3 ; Chemokines ; Collagen Diseases ; Humans ; Hypersensitivity ; Inflammation ; Interleukin-8 ; Lung Diseases, Interstitial ; Lung* ; Lymphocytes ; Macrophages ; Macrophages, Alveolar* ; Neutrophils ; Sarcoidosis ; T-Lymphocytes

BACKGROUND: Oxidative stress may play an important role in the pathogenesis of endotoxin-induced acute lung injury (ALI). This study evaluated the therapeutic effect of alpha-lipoic acid, a nonenzymatic antioxidant, in a rat model of lipopolysaccharide (LPS) induced ALI. MATERIALS AND METHODS: ALI was induced in Sprague-Dawley rats by instilling LPS (E.coli, 3mg/Kg) into the trachea. The rats were classified into the control, control+alpha-lipoic acid, LPS, and LPS+alpha-lipoic acid groups.The lung lavage neutrophil count, cytokine-induced neutrophil chemoattractant (CINC), lung myeloperoxidase (MPO), and cytokine concentrations (TNF-alpha, IL-1beta, IL-6 and IL-10) were measured at 2 h and 6 h after LPS administration. RESULTS: The total cell and neutrophil counts of the LPS+alpha-lipoic acid groups were significantly lower than the LPS groups. The protein concentration in the BAL fluid was similar in the LPS groups and LPS+alpha-lipoic acid groups. The TNF-alpha, IL-1beta, and IL-6 concentrations in the BAL fluid were not decreased by the alpha-lipoic acid treatment in the LPS treated rats. CONCLUSIONS: Although alpha-lipoic acid decreased the level of LPS-induced neutrophil infiltration into the lung, it could not attenuate the LPS-induced ALI at the dose administered in this study.
Acute Lung Injury* ; Animals ; Bronchoalveolar Lavage ; Interleukin-6 ; Lung ; Models, Animal ; Neutrophil Infiltration ; Neutrophils ; Oxidative Stress ; Peroxidase ; Rats ; Rats, Sprague-Dawley ; Thioctic Acid* ; Trachea ; Tumor Necrosis Factor-alpha

No abstract available.
Cell Line* ; Cell Proliferation* ; Cytokines ; Leukemia, Erythroblastic, Acute*

Salicylate, the active ingredient of aspirin can cause sensorineural hearing loss and tinnitus when plasma concentrations reach a critical level. The ototoxic mechanisms of salicylate remain unclear but hearing and tinnitus usually recovers a few days after intoxication. There have been few reports of salicylate-induced ototoxicity in Korea, and the majority is caused by a low dose of aspirin. Herein, we report a case of sudden hearing loss and tinnitus after acute salicylate intoxication and review recent updates on salicylate ototoxicity.
Aspirin ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Korea ; Plasma ; Sodium Salicylate ; Tinnitus

The major step toward successful tracheal transplantation is revascularization of the grafted trachea. There are many reports that although omentopexy is an effective method to facilitate neo-vascularization in tracheal transplantations, the procedure has not been accepted universally in the transplantation field. It remains unclear whether an omentopexy can successfully revascularize tracheal graft regardless of the length of graft. This study was undertaken to assess the usefulness of omentopexy for long-segment(more than 4 cm) tracheal allotransplantation. We have performed six tracheal transplantations with omentopexy (group A) and four tracheal transplantations without omentopexy (group B) in mongrel dogs from July 1993 to February 1995. Five mid-portion tracheal rings were removed from ten donor dogs and ten corresponding tracheal rings were removed from the ten recipient dogs. The excised tracheal rings from the donors were transplanted to the recipient tracheal-excised sites. All the recipients were given cyclosporine, azathioprine, and prednisolone for immunosuppression in the post-operative period. The histologic results of all the surviving members of group B were better than those of the group A. These findings indicate that omentopexy has a limitation, it is not a major method for graft revascularization. Therefore the length of the tracheal graft was greater than 4.0 cm, for its viability, a longer tracheal graft requires some other blood supply aside from the omentopexy.
Animal ; Dogs ; Omentum/*surgery ; Support, Non-U.S. Gov't ; Trachea/*transplantation ; Transplantation, Homologous

BACKGROUND: The triggering receptor expressed on myeloid cells-1 (TREM-1) is an activating receptor that is expressed on the surface of neutrophils and mature monocytes when stimulated with several microbial components, which can amplify the inflammatory response. This study analyzed the prognostic value of the sTREM-1 levels in patients with acute respiratory distress syndrome (ARDS). METHODS: The bronchoalveolar lavage (BAL) fluid and blood was collected prospectively from 32 patients with ARDS, 15 survivors and 17 nonsurvivors. An enzyme-linked immunosorbent assay was performed to measure the sTREM-1. The following data was obtained: APACHE II score, Clinical Pulmonary Infection Score (CPIS), BAL fluid analysis, C-reative protein. Mortality in the ICU was defined as the end point. RESULTS: The serum sTREM-1 level was significantly higher in the nonsurvivors than survivors (54.3+/-10.3 pg/ml vs. 22.7+/-2.3 pg/ml, p<0.05). The sTREM-1 level in the serum, but not in the BAL fluid, was an independent predictor of the ICU mortality (OR: 22.051, 95% CI: 1.780~273.148, p<0.016), and a cut-off value of > or =33 pg/ml yielded a diagnostic sensitivity of 71% and specificity of 93%. CONCLUSION: The serum sTREM-1 level may be a useful predictor of the outcome of ARDS patients.
APACHE ; Bronchoalveolar Lavage ; Enzyme-Linked Immunosorbent Assay ; Humans ; Monocytes ; Neutrophils ; Prognosis ; Prospective Studies ; Respiratory Distress Syndrome, Adult ; Survivors

No abstract available.
Angiography ; Catheters* ; Coronary Vessels* ; Spasm*

OBJECTIVES: The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic. METHODS: Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators. RESULTS: The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak. CONCLUSIONS Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.