BACKGROUND: We previously reported that IFN-gamma producing T cell responses induced by the combined therapy of DNA vaccine and lamivudine for one year are important for the induction of sustained virological response (SVR). However, IFN-gamma production is not sufficient to predict sustained viremia control in chronic hepatitis B (CHB) carriers treated. METHODS: Twelve CHB carriers were intramuscularly immunized 12 times at a 4-week interval with 8 mg of HBV DNA vaccine during the standard lamivudine treatment (100 mg/daily/1 year). The level of cytokines during and after the combined therapy in plasma of all 12 CHB carriers treated was determined by each ELISA kit. Six out of 12 CHB carriers revisited the clinic, and their HBV DNA levels were examined. RESULTS: The combined therapy increased plasma IL-12 and IL-12/p40 ratio during the treatment (baseline vs. peak level: 41.8+/-8.3 vs. 163.1+/-29.2 pg/ml; p<0.01 and 0.96+/-0.25 vs. 3.58+/-0.86; p<0.01, espectively), and the peak level of plasma IL-12 and IL-12/p40 ratio was evoked at 6 to 10 months during the combined therapy. In particular, CHB carriers with SVR had two and three-fold higher level of the peak plasma IL-12 and plasma IL-12/p40 ratio than non-virological responders (NVRs), respectively (218.0+/-41.4 vs. 108.1+/-28.6 pg/ml; p=0.09 and 5.35+/-1.38 vs. 1.80+/-0.29; p<0.05, respectively), while p40 level was consistent during the combined therapy. In addition, there was no significant temporal correlation between the peak IL-12/p40 ratio and the elevation of serum alanine aminotransferase (ALT) in this study, contrast to IFN-alpha therapy which induced peak IL-12 level following ALT flares. CONCLUSION: Our results indicate that the combined therapy induces the increase of plasma IL-12 and IL-12/p40 ratio, which are associated with long-term SVR in CHB carriers.
Alanine Transaminase ; Corynebacterium ; Cytokines ; DNA ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus ; Hepatitis B, Chronic ; Interleukin-12 ; Lamivudine ; Plasma ; Viremia

BACKGROUND: We previously reported that IFN-gamma producing T cell responses induced by the combined therapy of DNA vaccine and lamivudine for one year are important for the induction of sustained virological response (SVR). However, IFN-gamma production is not sufficient to predict sustained viremia control in chronic hepatitis B (CHB) carriers treated. METHODS: Twelve CHB carriers were intramuscularly immunized 12 times at a 4-week interval with 8 mg of HBV DNA vaccine during the standard lamivudine treatment (100 mg/daily/1 year). The level of cytokines during and after the combined therapy in plasma of all 12 CHB carriers treated was determined by each ELISA kit. Six out of 12 CHB carriers revisited the clinic, and their HBV DNA levels were examined. RESULTS: The combined therapy increased plasma IL-12 and IL-12/p40 ratio during the treatment (baseline vs. peak level: 41.8+/-8.3 vs. 163.1+/-29.2 pg/ml; p<0.01 and 0.96+/-0.25 vs. 3.58+/-0.86; p<0.01, espectively), and the peak level of plasma IL-12 and IL-12/p40 ratio was evoked at 6 to 10 months during the combined therapy. In particular, CHB carriers with SVR had two and three-fold higher level of the peak plasma IL-12 and plasma IL-12/p40 ratio than non-virological responders (NVRs), respectively (218.0+/-41.4 vs. 108.1+/-28.6 pg/ml; p=0.09 and 5.35+/-1.38 vs. 1.80+/-0.29; p<0.05, respectively), while p40 level was consistent during the combined therapy. In addition, there was no significant temporal correlation between the peak IL-12/p40 ratio and the elevation of serum alanine aminotransferase (ALT) in this study, contrast to IFN-alpha therapy which induced peak IL-12 level following ALT flares. CONCLUSION: Our results indicate that the combined therapy induces the increase of plasma IL-12 and IL-12/p40 ratio, which are associated with long-term SVR in CHB carriers.
Alanine Transaminase ; Corynebacterium ; Cytokines ; DNA ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus ; Hepatitis B, Chronic ; Interleukin-12 ; Lamivudine ; Plasma ; Viremia

Trichoadenoma is a rare cutaneous tumor that was first described by Nikolowski in 1958. It usually occurs as a single tumor on the face and its size varies from 3 to 50mm in diameter. It may arise any time during adult life. This tumor is less mature than trichofolliculoma and more differentiated than trichoepithelioma, and it is considered as a benign tumor with differentiation toward the infundibular portion of the pilosebaceous canal. In this report, we describe a 61-year-old women who developed trichoadenoma on the left shoulder of 3 years duration. The lesion was asymptomatic and had grown slowly. Histopathological findings showed numurous horn cysts with central keratinous material and solid tumor islands reaching to the deep dermis. Immunohistochemical studies showed negative findings for eccrine differentiation.
Adult ; Animals ; Dermis ; Female ; Horns ; Humans ; Islands ; Middle Aged ; Shoulder

OBJECTIVES: The purpose of this study was to determine the prevalence and related factors of upper limb musculoskeltal symptoms among workers in automobile related jobs. METHODS: Two-hundred and twenty-one workers were volunteered in this 'study consisting of 112 seat installers and 109 auto mechanics. A questionnaire was administered to the workers consisting of questions on demographics, work type and duration, sleep hours, health habits, and standardized descriptions of NJOSH on musculoskeletal symptoms. RESULTS: Complaint rates of neck and upper extremity musculoskeletal symptoms by anatomical site were as follows: shoulder, 52.0%; neck, 47.1%; wrist and hand, 39.4 elbow, 26.2% and; arm, 24.4%. Significantly higher prevalence of shoulder musculoskele tal symptom was found in middle school than high school graduate, married than unmar ned, less than 6 hours sleep than over 6 hours sleep and, seat installer than auto mechanic group. A significantly higher prevalence of arm, elbow, hand and wrist mus loskeletal symptoms was disclosed in the less than 6 hours sleep than over 6 hours sleep group and the seat installer than the auto mechanic group. Multiple logistic regression analysis identified education, sleep hours and, job type as the main affecting factors for shoulder musculoskeletal symptoms. Sleep hours and job type were the main affecting factors for wrist and hand musculoskeletal symptoms. Sleep hours were the main affecting factors for arm and elbow musculoskeletal symptoms. CONCLUSIONS: The prevalence of neck and upper limb musculoskeletal symptoms was high in workers who did routine tasks at confined places like seat install-line work. It is recommended that workers performing simple and routine tasks be provided adequate sleep time since lack of sleep was the main affecting factor for most upper limb mus loskeletal symptoms in automobile factory related jobs workers.
Animals ; Arm ; Automobiles* ; Demography ; Education ; Elbow ; Hand ; Humans ; Logistic Models ; Mechanics ; Mice ; Neck ; Prevalence* ; Questionnaires ; Shoulder ; Upper Extremity* ; Wrist

PURPOSE: To report a case of herpes simplex keratitis after descemet stripping automated endothelial keratoplasty (DSAEK). CASE SUMMARY: A 66-year-old male underwent DSAEK in his right eye due to bullous keratopathy after cataract surgery. The corneal epithelium which was removed during surgery was healed, but the patient was experiencing pain and decreased visual acuity in his right eye 1 month after surgery. Increasing corneal epithelial defects and corneal edema were observed on slit-lamp examination. Therapeutic soft contact lenses and artificial tears were used for treatment but were not effective, thus amniotic membrane transplantation was performed. Three months after transplantation, the epithelial defect appeared as a geographic ulcer suspecting to be herpes simplex keratitis; therefore, ganciclovir ophthalmic ointment and oral acyclovir were administered. Six months after antiviral therapy, the epithelial lesion of herpes simplex keratitis completely disappeared, leaving only mild corneal opacity. CONCLUSIONS: If corneal epithelial defects are persistent after DSAEK in patients even with no past history of herpes simplex keratitis, herpes simplex keratitis should be considered in the differential diagnosis.
Acyclovir ; Aged ; Amnion ; Cataract ; Contact Lenses, Hydrophilic ; Corneal Edema ; Corneal Transplantation ; Diagnosis, Differential ; Epithelium, Corneal ; Eye ; Ganciclovir ; Herpes Simplex ; Humans ; Keratitis, Herpetic ; Male ; Methylmethacrylates ; Ophthalmic Solutions ; Polystyrenes ; Transplants ; Ulcer ; Visual Acuity

The cystic mesothelioma is a very rare tumor which has a clinically and histologically benign nature. Here in reported is the case of a cystic mesothelioma presented as a palpable mass of the inguinal area in a 28-year-old male. Ultrasound showed a cystic tumor at the inguinal canal, and the other physical and laboratory examinations were within normal limits. Grossly, the tumor consisted of cysts containing clear serous fluid and focally solid areas. Microscopically, the tumor was encapsulated with fibrocollagenous wall, and the tumor cells were cuboidal or polygonal epithelial cells with single or multiple layers and had clear cytoplasm. Some areas showed thyroid follicle-like structures. The content of follicle-like structures showed eosinophilia in the H&E section, but positive in mucin stain. Neither cytologic atypia nor mitoses were present. Immunohistochemical staining revealed positive reaction for keratins of low molecular weight, while negative for the thyroglobulin and CEA. These findings suggested mesothelial in origin. We concluded that this tumor was primary rather than metastatic, because he had no evidence of a tumor in gastrointestinal, genitourinary tracts and scrotum.
Adult ; Cytoplasm ; Eosinophilia ; Epithelial Cells ; Humans ; Inguinal Canal ; Male ; Mesothelioma, Cystic* ; Mitosis ; Molecular Weight ; Mucins ; Scrotum ; Thyroglobulin ; Thyroid Gland ; Ultrasonography

We report the imaging features of four cases with calcified intracranial aneurysm. All four patients underwentCT, CT angiography, MR, magnetic resonance angiography, and angiography. Calcification of the aneurysm wall was clearly demonstrated with CT and CTA in all cases and with conventional angiography in one case. The shape of calcification was curvilinear in two cases and punctate in two. On MR, two curvilinear calcifications were demonstrated as peripheral rim of signal void but two punctate calcifications were not shown.
Aneurysm* ; Angiography ; Cerebral Angiography ; Humans ; Intracranial Aneurysm ; Magnetic Resonance Angiography

BACKGROUND AND PURPOSE: The "closing-in" phenomenon refers to the tendency to copy near or overlap a model while performing figure-copying tasks. The mechanisms underlying the closing-in phenomenon have not been fully elucidated, and previous studies only investigated the mechanisms through neuropsychological tests. We investigated the neuroanatomical correlates of the closing-in phenomenon using voxel-based morphometry (VBM). METHODS: Thirty-eight patients diagnosed with probable Alzheimer's disease (AD) and 21 normal controls were included. All subjects underwent neuropsychological testing to diagnose dementia and magnetization prepared rapid acquisition gradient echo brain magnetic resonance imaging for the voxel-based statistical analysis. The subjects were asked to copy the modified Luria's alternating squares and triangles to quantify the closing-in phenomenon. We applied SPM8 for the VBM analysis to detect gray matter loss associated with the closing-in phenomenon. RESULTS: The patients with probable AD showed a higher closing-in score than that of the normal control subjects (p<0.0001). The VBM analysis revealed more parietal and temporal atrophy in the patients with AD than that in the normal control group. Moreover, atrophy of the orbito-frontal area was associated with the closing-in phenomenon. CONCLUSIONS: The closing-in phenomenon is dysfunction while performing figure-copying tasks and is more common in patients with AD. The analysis of the orbito-frontal area, which is associated with inhibiting primitive reflexes, revealed that the closing-in phenomenon is an imitation behavior commonly observed in patients with frontal lobe damage.
Alzheimer Disease ; Atrophy ; Brain ; Dementia ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Rabeprazole ; Reflex

BACKGROUND AND OBJECTIVES: The Herpes Simplex type 2 Defective Infectious Single Cycle virus (DISC virus) is an attenuated virus originally produced as a viral vaccine, but it also serves as an efficient gene transfer vehicle. The main goals of this study were to examine determinants of gene transfer using DISC vectors for squamous cell carcinoma and to evaluate the efficacy of vaccination with the DISC virus carrying a combination of immunomodulatory genes (IL-2, GM-CSF) as cancer therapy in a model of squamous cell cancer in the C3H/HeJ mice. MATERIALS AND METHODS: We determinated the gene and protein expression of DISC-IL-2 and DISC-GM-CSF transfected SCCVII cells by RT-PCR and ELISA method. Also, we evaluated the ex vivo vaccination effects of DISC-IL-2 and DISC-GMCSF on preventing the development of SCCVII tumor. RESULTS: SCCVII cells transduced by the DISC virus vector (MOI=10) carrying the IL-2, or the GM-CSF gene, produced nanogram quantities of IL-2 or GM-CSF per 10(6) cells. Of particular interest was the observation that cells irradiated at different doses (5,000 cGy, 10,000 cGy) secreted levels of GM-CSF or IL-2 that were comparable to non-irradiated cells. In vivo vaccination using tumor cells transduced ex vivo with DISC-IL-2 or DISC-GMCSF resulted in protection against subsequent tumor challenge (p<0.01). Among the multiple immunomodulatory transgenes vaccination groups, the DISC-GMCSF transfected vaccine showed the greatest suppression of tumor development and growth (p<0.001). CONCLUSION: These data demonstrate that: 1) The DISC virus vector is capable of efficient gene transfer to SCCVII cells, 2) The GM-CSF secreting, genetically modified tumor vaccine (SCCVII/GMCSF) efficiently protected against tumor cell challenge and suppressed tumor growth in our tumor model. The DISC virus-mediated, cytokine gene transfer may prove to be useful in clinical therapy for head and neck cancers.
Animals ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Genetic Therapy* ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Growth and Development ; Head* ; Herpes Simplex ; Interleukin-2* ; Mice ; Neck* ; Neoplasms, Squamous Cell* ; Transgenes ; Vaccination

PURPOSE: To evaluate clinical effects of intracameral voriconazole injection in fungal keratitis refractory to conventional therapy. METHODS: Thirty-eight eyes of 38 patients with fungal keratitis were included in this study. The patients were divided into 3 groups: 13 patients with intracameral voriconazole injection (50 microg/0.1 ml; group A), 11 patients with intracameral amphotericin B injection (10 microg/0.1 ml; group B), and 14 patients with conventional therapy only (group C). Clinical factors including treatment success rate and time to successful treatment were evaluated. RESULTS: Treatment success was accomplished in 12 eyes in group A (92.3%), 10 eyes in group B (90.9%), and 12 eyes in group C (85.7%). Time to treatment success in group A, B, and C was 36.1 +/- 10.4 days (p = 0.04), 34.2 +/- 7.8 days (p = 0.03), and 49.5 +/- 16.7 days, respectively. Patients who had received intracameral voriconazole injection or amphotericin B showed faster fungal keratitis improvement than patients who received conventional treatment. Time to re-epithelialization and time to disappearance of hypopyon showed a similar clinical course. CONCLUSIONS: Intracameral voriconazole injection, which has a similar therapeutic effect as intracameral amphotericin B injection in the management of fungal keratitis, can be helpful in the treatment of intractable fungal keratitis.
Amphotericin B ; Eye ; Humans ; Keratitis ; Pyrimidines ; Re-Epithelialization ; Time-to-Treatment ; Triazoles