BACKGROUND: Th2-like cells are thought to play a crucial role in the recruitment and activation of eosinophil in bronchial asthma. In contrast to Th2 cytokine, Thl cytokine IFN-y decreases eosinophil recruitment. Previous studies have shown that IL-12 promotes differentiation of Th0 into Thl and enhances production of Thl cytokine. IL-12 also prevents differentiation of Th0 into Th2 during primary immune response. Its effect on established Th2 cell, however, is well known. OBJECTIVE: The objective of aur study was focused on whether IL-12 prevents recruitment of eosinophil and expression of Th2 cytokine in murine model for bronchial asthma, and whether its effect differs according to timing of dosage. METHOD: Administration of IL-12 was tested in the 3 different time-frames; 1) allergic sensitization (early dosage) 2) allergic challenge (late doaage) or 3) both. The number of eosinophil in the bronchoalveolar lavage(BAL) fluid and tissue was examined for change of airway inflammation. The effect on cytokine expression was assessed by measuring cytokine in bronchoalveolar lavage fluid (ELISA) and mRNA in peribronchial lymph node (RT-PCR) RESULTS: Early dosage of IL-12, and the combination of early and late dosages, strikingly decreased the numbers of eosinophil in both BAL fluid and tissue(p<0.05). Late dosage of IL-12 decreased tissue eosinophilia, while the number of eosinophil in BAL fluid remained unchanged. IL-12 increased IL-4 and IL-5 levels, and decreased IL-2 and I~FN-r levels. There were no differences in Thl/Th2 cytokine regulation among the three dosage times. Early dosage of IL-12, and the combination of early and late dosages, increased IL-10 level, but late dosage had no effect on IL-10. CONCLUSION: These results demonstrate that depending upon whether IL-12 is administered during sensitization or during subsequent allergen exposure, Thl/Th2 cytokine regulation by IL -12 shows no difference because it seems that difference of inhibition of eosinophil recruitment by IL-12 might be related with the other factors, such as IL-10.
Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils ; Inflammation* ; Interleukin-10 ; Interleukin-12* ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Lymph Nodes ; Mice* ; RNA, Messenger ; Th2 Cells

Heat stroke, a medical emergency, occurs when the body's thermal regulation is upset and unable to dissipate adequate amounts of heat with a rise in body temperature. It is characterized by hyperyrexia, with a core temperature of 40degrees C or more, hot dry skin, and central nervous system disturbance and usually results in rhabdomyolysis and multiorgan failure. Our case, a 43-year-old healthy male, was caused by a marathon, half course, on a sunny day in late summer. He suddenly fell down on the road and was delivered to a nearby hospital, where a seizure developed. He was transfered to our hospital and then displayed Central Nervous System disturbance, hot dry skin, acute liver failure, rhabdomyolysis, anuric acute renal failure, and disseminated intravasculular coagulopathy. He was treated with general supportive care and hemofiltration. Despite the aggressive management, he died of shock on the fifth day after admission.
Acute Kidney Injury ; Adult ; Body Temperature ; Central Nervous System ; Emergencies ; Heat Stroke* ; Hemofiltration ; Hot Temperature* ; Humans ; Liver Failure, Acute ; Male ; Rhabdomyolysis ; Seizures ; Shock ; Skin

BACKGROUND: The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. METHODS: We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center from April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. RESULTS: Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). CONCLUSION: At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intubation ; Intubation, Intratracheal* ; Paralysis ; Retrospective Studies ; Succinylcholine ; Tertiary Care Centers* ; Tertiary Healthcare* ; Tracheostomy

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans

No abstract available.
Electrocardiography*

BACKGROUND: Maritime medicine refers to the medical care and education of medical disease which may develop during a cruise. Recently, cruise passengers are increasing around the world and maritime medicine has been initiated in Korea with beginning of the trip to Mt. Kumgang in 1998. Nowadays, there are about 4,000 passengers per week. Therefore, the data were analyzed to promote the understanding of maritime medicine, which was first applied on the Mt. Kumgang cruise, and to help the medical members who will be participation in the maritime medicine in the future. METHODS: From November 1998 to February 1999, all patients who visited to medical cabin of the cruise ship(Hyundai Pongnae) were analyzed retrospectively. RESULT: 2,162 patients excluding 182 patients who re-admitted were analyzed. In each cruise, there were 65.5(9.0%) passengers and 42(13.0%) crews. The male to female ratio was 1.6 : 1, with 709 males and 451 females. The common problems were respiratory and musculoskeletal diseases followed by dematologic and gastrointestinal problems in order of frequency. There were 18 patients who had trauma above 4 points in ISS. Ten patients were confined to the medical cabin. The ship returned to Donghae-port one time, 8 patients were evaluated immediately and 41 patients were referred without urgency. CONCLUSION: Maritime medicine has a particular characteristic of dealing with various cases and treatments including emergencies with limited space, man-power, facilities and equipment. It obviously proposes the participation emergency medical doctors in the maritime medicine because medical personnel must take part in not only medical management but also in education and prevention including CPR. The medical staff in charge of maritime medicine should establish a proper plan depending on the purpose of the cruise and must endeavor to solve the problem.
Cardiopulmonary Resuscitation ; Education ; Emergencies ; Female ; Humans ; Korea ; Male ; Medical Staff ; Musculoskeletal Diseases ; Retrospective Studies ; Ships

No abstract available.
Animals ; Cyclophosphamide* ; Food Deprivation* ; Mice*

No abstract available.
Animals ; Cyclophosphamide* ; Food Deprivation* ; Mice*

No abstract available.
Emergencies* ; Emergency Service, Hospital*

PURPOSE: To evaluate value of superparamagnetic iron oxide (SPIO) as a negative oral contrast agent in MR cholangiopancreatography (MRCP). MATERIALS AND METHODS: Forty-eight patients with suspected biliary tract or pancreatic diseases and six healthy volunteers were enrolled in this study. All MR images were obtained using a 1.5 T MR unit. MRCP using fat-suppressed half-Fourier acquisition single-shot turbo spin echo (HASTE) and turbo spin echo (TSE) techniques were performed and reconstructed with maximal intensity projection (MIP). To determine the most optimal concentration of SPIO to obliterate the high signal intensity of water, a phantom experiment was conducted with various concentrations of SPIO-water mixture. Two radiologists evaluated pre- and postcontrast MRCPs. The contrast enhancement was assessed on the basis of loss of signal intensity in the stomach and duodenum. RESULTS: In the phantom experiment, a significant increase of percentage of signal intensity loss (PSIL) occurred in concentration of 22.4 ugFe/ml (Feridex 1 ml diluted with water 500 ml). Postcontrast MRCP showed an improved image quality compared with precontrast images. The rate of improvement in the diagnosis of diseases of the common bile duct and pancreatic duct was 25% (12/48). CONCLUSION: In patients with suspected biliary tract and pancreatic diseases, the SPIO is useful as a negative oral contrast agent for MRCP and provides an improvement of image quality.
Biliary Tract ; Common Bile Duct ; Diagnosis ; Duodenum ; Healthy Volunteers ; Humans ; Iron* ; Pancreatic Diseases ; Pancreatic Ducts ; Stomach ; Water