To delineate the individual role of follicular dendritic cells (FDC) and T cells at each stage of GC B cell differentiation at the clonal level and to analyze the signals required for the differentiation, we developed an experimental model using an FDC line, HK and a lymphoma cell line, L3055 for centroblasts. Phenotypic analysis of L 3055 revealed its origin of GC and the homogeneity. L3055 cells undergo spontaneous apoptosis when cultured in the absence of HK cells. L3055 cells proliferate continuously in the presence of HK cells, while they differentiate into a population with the phenotype of centrocytes after stimulation with CD40 ligand (CD 40L) plus IL-2, IL-4 and IL-10. L3055 undergo anti-Ig-mediated apoptosis, which is not protected by HK but by CD40L and the cytokines. These experimental results suggest that FDC provide signals for the survival and rapid proliferation of centroblasts and T cells trigger the differentiation of centroblasts into centrocytes.
Apoptosis ; CD40 Ligand ; Cell Differentiation* ; Cell Line ; Cytokines ; Dendritic Cells, Follicular ; Germinal Center* ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Lymphoma ; Models, Theoretical ; Phenotype ; T-Lymphocytes

BACKGROUND: Many of the major life events that appear to affect biologic system and health occur within the context of the family and can have a profound psychosocial and biologic impact on family memebers. So, the present study attempted to examine the relations of family function with stressful life events, depression, and physical and psychological symptoms reported by patients. METHODS: Design : Cross sectional, observational study. Participants : 41 healthy adult males from a family medicine ambulatory care unit in a tertiary hospital located in Guro completed a series of psychometric instruments that include the Family APGAR(Adaptation, Partnership, Growth, Affection, and Resolve), FACESIII(Family Adaptability and Cohesion Evaluation Scale), Modified 46-item Stressful Life Events Scale, Lee's 98 items Stressful Life Event Scale, Korean version of BEPSI(Brief Encounter Psychosocial Instrument) and BDI(Beck's Depression Inventory Scale). RESULTS: Family APGAR was negatively correlated with stress related life events(both in total and negative events, -0.30, -0.37, respectively; p<0.05) and BEPSI(-0.56; p<0.0001). No significant correlation could be found between family function and positive life events. Family APGAR also revealed significant negative correlation with BDI(-0.61; p<0.0001). Among the three family types, severe dysfunctional family demonstrated highest level of stressful life events score, perceived stress, and depression(p<0.05). CONCLUSIONS: The higher the assessment of the family function(Family APGAR), the lower the level of stressful life events, perceived stress and depression. There, knowledge of the family function, stress, and coping could be useful to family physicians in the whole person approach of their patients.
Adult* ; Ambulatory Care ; Depression* ; Humans ; Male* ; Observational Study ; Physicians, Family ; Psychometrics ; Tertiary Care Centers

BACKGROUND: Compliance with self-care and lifestyle modification is recommended for all patients with acute coronary syndrome to prevent a secondary attack. Data is limited regarding the association between compliance with self-care and restenosis. This study was conducted to examine the association between compliance with self-care and restenosis and to determine the predicting factors for restenosis and low compliance with self-care. METHODS: A total of 166 acute coronary syndrome patients (64.2+/-10.8 years) hospitalized for an angiogram during routine follow-up or symptom management were conveniently recruited from a university hospital cardiovascular care unit. Self-administered questionnaires were used to evaluate the level of compliance with self-care and symptom-related satisfaction. RESULTS: In-stent restenosis was found in 40.4% of the subjects and 36.1% were persistently smoking. There was no significant relationship between low compliance with self-care and restensosis. A lower symptom-related satisfaction significantly predicted restenosis and low compliance with self-care. A longer period after initial diagnosis predicted restenosis and a shorter period after initial diagnosis predicted low compliance with self-care. Persistent smoking was independently associated with low compliance with self-care. CONCLUSIONS: Patients who continued to smoke and had lower symptom-related satisfaction with daily living showed a stronger tendency for lower compliance with self-care and lifestyle modification. Effective educational strategy focusing on smoking cessation is needed to increase compliance with self-care in patients with ACS, especially during admission with a first heart attack.
Acute Coronary Syndrome ; Compliance ; Coronary Artery Disease ; Follow-Up Studies ; Heart ; Humans ; Life Style ; Patient Compliance ; Self Care ; Smoke ; Smoking ; Smoking Cessation ; Surveys and Questionnaires

Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

The uterine cervical cancer is the rnost common tumor of malignant gynecologic tumors and complete remission of the cancer has been possible through early diagnosis and treatment. To evaluate the efficacy of tumor markers SCCA and CEA in patients with uterine cervical cancer as markers for monitoring, we analyzed serum SCCA and CEA crncentrations of 43 patients wit.h uterine cervical caner as a study group and 73 patients with benign pelvic disease as a contrnl group, were admitted to depar tment of Obstetncs & Gynecology, College of Medicine, Kyung Hee University from May 1991 to January 1993. The results were as follows ; 1. The distrihution of the clinical stages of 43 cervical cancers were : CIS 9, stage I 11, stage II 12, stageg III 5, stage lV 6. 2. The positive rate of SCCA of control group was 17%, and that of CEA nf control group was 12%. And the positive rate of SCCA of study group was 46.5% and that of CEA of study was 27.9%. 3. The average concentration of SCCA of control group was 0.71ng/ml and that of SCCA of study group was 8.25ng/ml(p<0.05). 4. The average concentration of CEA of control group was 1.95ng/ml and that of CEA of study group was 8.33ng/ml(p<.0.05). 5. The average concentration of SCCA by stage were 1.15ng/rnl for C1S, 1.14ng/ml for stage I, 9.72ng/rnl for stage III, 16.75ng/rnl for stage III, 21.95ng/ml for stage IV. Here, the mean value of SCCA was increased stepwise through cliinical stage, there was a correlation between the clinical stage and the concen tration of serum SCCA (p>0.05). 6.The average concentration of CEA by stage were 3.11ng/ml for CIS, 1.96ng/ml for stage I, 8.11ng/rnl for stage II, 18.92ng/ml for stage III, 19.44ng/ml for stage IV. There was not a correlation between the clinical stage and the concentration of serm CEA. 7. When the cervical cancer was divided by histologic subtypes, the average concentration of SCCA in squamous cell carcinoma of uterine cervix was 11.86ng/ml and the positive rate of SCCA in squamous cell carcinoma was 53.6%(9.46ng/ml & 58.8% in large keratinizing cell type, 15.56ng/ml & 45.5% in large nonkeratinizing cell type). And the average concentration of SCCA in adenocarcinoma was 1.32ng/ml positive rate was 40.0%. The tumor marker SCCA was more sensitive to squamous cell carcinoma rather than adenocarcinoma. 8. The sensitivities of SCCA in preinvasive cancer and invasive cancer were 22.2% and 52.9%, respectively. The average concentration of SCCA in invasive cancer was 10.04ng/ml and was more significantly elevated than of SCCA in preinvasive cancer. 9. Using SCCA & CEA together as markers for monitoring, the positive rate significantly incresaed to 70.6%(p<0.05). But measuring the two tumor marker alone, that not significantly increased. 10) . The diagnostic efficacy of SCCA in cervical cancer was 59.0%, that was higher as compaired with that of CEA. These results suggest that the serum concentration of SCCA is significantly increased stepwise by clinical stage and concomitant measurements of serum SCCA & CEA are more useful in diagnosis of cervical cancer. However measurements of SCCA and/or CEA have little efficacy in the detection of early cervical cancer considering it's low rate of positivity in early cervical cancer. We will evaluate the efficacy of two tumor markers in determining prognosis, therapeutic response and early detection of recurrence for the posttreatment patients in the future.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Early Diagnosis ; Female ; Gynecology ; Humans ; Prognosis ; Recurrence ; Selective Estrogen Receptor Modulators ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*

In the past, arthrodesjs was a widely used procedure but in recent times, with the development of replacement arthroplasty, decreased in tuberculosis and polio. etc, it is not commonly used by orthopedic surgeons. However, for those in the young age group, people employed in hard labor and patients with acute inflammatory disease, arthrodesis is through to be more appropriate than replacement arthroplasty. From January 1980 to December 1985, 20 cases of arthrodesis of the knee joint were carried out. The results were follows.; 1. Methods of arthrodesis used were Charnley compression arthrodesis in 10 cases, Hoffman compression arthrodesis in 2 cases, cross pinning in 3 cases and and cross pinning with patella graft in 5 cases. 2. Bone union was seen in all 12 cases of compression arthrodesis at an average of 21.3 weeks while bone union was seen in 7 out of 8 cases of non-compression arthrodesis at an average 25 weeks. 3. Among the 20 cases, complication were pseudoarthrthrosis in one case, pin tract infection in 2 cases and skin necrosis in 5 cases. 4. Inconclusion of the above results, bone union was carried out in 19 cases out of total 20 cases, and compression arthrodesis showed faster bone union at an average of 3.7 weeks earlier than non-compression arthrodesis.
Arthrodesis ; Arthroplasty, Replacement ; Humans ; Knee Joint ; Knee ; Necrosis ; Orthopedics ; Patella ; Poliomyelitis ; Skin ; Surgeons ; Transplants ; Tuberculosis

BLAST, a basic bioinformatics tool for searching local sequence similarity, has been one of the most widely used bioinformatics programs since its introduction in 1990. Users generally use the web-based NCBI-BLAST program for BLAST analysis. However, users with large sequence data are often faced with a problem of upload size limitation while using the web-based BLAST program. This proves inconvenient as scientists often want to run BLAST on their own data, such as transcriptome or whole genome sequences. To overcome this issue, we developed NBLAST, a graphical user interface-based BLAST program that employs a two-way system, allowing the use of input sequences either as “query” or “target” in the BLAST analysis. NBLAST is also equipped with a dot plot viewer, thus allowing researchers to create custom database for BLAST and run a dot plot similarity analysis within a single program. It is available to access to the NBLAST with http:/bitglobal.comblast.

Hand-foot-and-mouth disease (HFMD) is a viral illness with a distinct clinical presentation of oral and characteristic distal extremity lesions. It is caused by members of the enterovirus genus, namely, coxsackievirus A16 or enterovirus 71. HFMD is more severe in infants and children than adults, but generally, the disease has a mild course and is self-limiting. However, in recent epidemiology of HFMD in Asia, severe cases with complications have been reported. Enterovirus 71 may cause myocarditis, pneumonia, and severe neurological complications such as brainstem encephalitis, aseptic meningitis, acute flaccid paralysis, meningoencephalitis, meningomyeloencephalitis, and even death. A large outbreak of HFMD in Taiwan and Singapore caused by enterovirus 71 had a high mortality rate; the deaths resulted from pulmonary hemorrhage, interstitial pneumonitis, or brainstem encephalitis. HFMD was also epidemic in Korea in the spring of 2010. Severe cases with complications including neurological complications and death have been reported in HFMD patients, thus it has become a public health issue. We report five children who had severe HFMD caused by enterovirus 71 with meningomyeloencephalitis which caused a disturbance in consciousness, motor weakness, strabismus, and voiding difficulty. There was no mortality, and no patients exhibited sequelae.
Adult ; Asia ; Brain Stem ; Child ; Consciousness ; Encephalitis ; Enterovirus ; Extremities ; Foot ; Hand ; Hemorrhage ; Humans ; Infant ; Korea ; Lung Diseases, Interstitial ; Meningitis, Aseptic ; Meningoencephalitis ; Mouth ; Mouth Diseases ; Myocarditis ; Paralysis ; Pneumonia ; Public Health ; Singapore ; Strabismus ; Taiwan

BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests