This study was designed to investigate the mole- cular mechanism of chemokine induction by lipopoly-saccharide(LPS) of E. coli. Chemokine gene expression was evaluated by the reverse transcriptase-polymerase chain reaction(RT-PCR) assay using RNAs isolated either from kidneys of LPS-injected inice or from the mesangial cells stimulated with LPS, IFN-r or TNF-a. LPS was shown to induce interferon gamma(IFN- 7 ) inducible protein 10 (IP-10) and monokine induced by interferon gamma (MIG) in kidney. IP-10 gene expression was induced by LPS and IFN-r, but MIG gene expression was induced by IFN-r in mesangial cell. Chemokines induced by LPS increased splenocyte migration. Sodium salicylate, wortmanin and piperazine blocked LPS mediated chemokine induction suggesting the activation of nuclear factor-a B pathway. It is concluded from this study that mesangial cells are the target of LPS in the renal failure resulting from the systemic infections. LPS induces chemokines directly and/or indirectly in the mesan- gial cells, and these chemokines may associated with renal inflammation.
Chemokines ; Gene Expression* ; Inflammation ; Interferons ; Kidney ; Mesangial Cells* ; Renal Insufficiency ; RNA ; Sodium Salicylate

Congenital cystic adenomatoid malformation (CCAM) of the lung is a rare pulmonary malformation, associated with local aberrations of parenchymal tissue development, which have been classified lung bud anomalies. Lung bud anomalies include infantile lobar emphysema, congenital cyst of the lung, congenital cystic adenomatoid malformation, pulmonary sequestration and bronchogenic cyst. CCAM can enlarge rapidly by ball-valve air entrapment by cysts, lead to mediastinal shift and compression of the heart. compression of opposite lung may result in pulmonary hypoplasia and CCAM causes acute respiratory distress in newborn. We report a neonate with CCAM who were successfuly managed during perioperative period.
Bronchogenic Cyst ; Bronchopulmonary Sequestration ; Cystic Adenomatoid Malformation of Lung, Congenital ; Emphysema ; Heart ; Humans ; Infant, Newborn* ; Lung ; Perioperative Period

We observed three patients who showed widespread macular ashy-colored eruptions. They fit clinically and histopathologically with the typical erythema dyschromicum perstans (ashy dermatosis). Erythoma dyschromicum perstans is a peculiar pigmented condition of unknown etiology characterized by persistent ashy-gray colored macule, refractory to any modality. All of them have similar skin lesions which are multiple, variable sized oval-shaped, ash-colored macular eruption on the trunk and extremities. Histologic findings of 2 patients reveal the characteristic feature of focal hydropic degeneration of the basal cell layer of the epidermis, perivascular infiltrates of lymphocytes and histiocytes and melanin-laden macrophages in the corium, however, merely pigmentary incontinence into the corium in 1 patient. Literatures are briefly reviewed.
Dermis ; Epidermis ; Erythema* ; Extremities ; Histiocytes ; Humans ; Lymphocytes ; Macrophages ; Skin

BACKGROUND: Handgrip and cold pressor test may increase the afterload of the heart. And in left ventricular hypertrophy, it is known that mitral flow pattern is affected by decreased left ventricular compliance. We investigated the effects of handgrip and cold pressor test on mitral flow pattern in patients with left ventricular hypertrophy. METHODS: Handgrip and cold pressor test were performed in 12 subjects with left ventricular hypertrophy and in 14 healthy normal subjects. In supine position, blood pressure, heart rate and Doppler echocardiographic parameters(early peak flow velocity : E, atrial peak flow velocity : A) were obtained at rest, 1 and 3 minutes after the onset of tests respectively. RESULTS: In both groups, handgrip and cold pressor test increased blood pressure slightly without a statistical significance. In left ventricular hypertrophy group, there were significant increments in heart rates at 1 minute of handgrip (78+/-12min-1, p<0.001) and cold pressor test(77+/-7min-1, p<0.05) as compared to that at rest (73+/-12min-1). Mitral flow velocities did not show significant change after the tests in control group. A waves after 1 minute of handgrip(85.2+/-18.4cm/sec, p<0.05) and cold pressor test (87.3+/-17.8cm/sec, p<0.001) showed significant increases as compared to that at rest (79.1+/-14.9cm/sec) in left ventricular hypertrophy group whereas E waves did not. CONCLUSION: Although handgrip and cold pressor tests did not affect the mitral flow significantly in control group, each test raised A waves in left ventricular hypertrophy group. These results suggest that increased A waves may be due to a rise in afterload and decreased left ventricular compliance caused by handgrip and cold pressor test in left ventricular hypertrophy group.
Blood Pressure ; Compliance ; Echocardiography ; Heart ; Heart Rate ; Humans ; Hypertrophy, Left Ventricular* ; Supine Position

By recent advance of immunologic techniques, it made possible to measure the immune cells and NK cell activity in peripheral blood of various immune altered eonditions. NK cell activity is related not only to malignancies but also to viral infectiona. The facts that the impairment of cell mediated immunity inducea the herpes zoster infection and frequent association with herpes zoster in the patienta with malignancy promote author to atudy the alteration of immune cells and NK cell activity in peripheral block. So author evaluated irnmune cells and NK cell activity of 18 patients with berpes zoster. The results are as follows; 1. The mean value of T cells, T cells showed significant differences between patients group(58.4-i-6.9%, 33.7-+11.7%) and normal healthy control group (68. 6+ 4. 7yo, 44. 2+-7. 0%) but T,' and B cells showecl no significant between patientagroup(6.9-+2.4%, 12.5+-5.7%) and.controlgroup(7.8-1.5%, 13.9-+2.3g%), statistically. 2. The mean value of NK cell activity in patients with herpes zoster group (62. 9+-ll. 2%) showed no significance cornpaired with the mean value of normal healthy control group(57. 9+-l4. 8%), statiatically.
B-Lymphocytes ; Herpes Zoster* ; Humans ; Immunity, Cellular ; Immunologic Techniques ; Killer Cells, Natural* ; T-Lymphocytes

Acropustulosis of infancy is an uncommon, but not rare syndrome established as a new disease entity by Kahn and Rywlin(1976), which is characterized by recurrent, intensely pruritic vesicopustules on the distal extremities. We'd like to report a case of acropustulosis of infancy. Our patient was 19 month old girl who had been suffering from her skin disease since the age of 12 months. Intensely pruritic, 1 to 2 mm vesicopustules erupted on the palms, soles and the ventral aspects of the fingers. There were no bacteria, fungus and parasites(Sarcoptes scabiei) on the pustular lesions. Histopathologically, biopsy specimen of the left sole revealed large, well circumscribed intraepidermal pustule which was filled wth polymorphonuclear leukocytes. We confirmed our case as typical case of acropustulosis of infancy by it's characteristic clinical features and histopathologic findings. Severity of the skin lesions seems closely related to the dosage of dapsone. The eruptions were unresponsive to topical steroid, antibiotics and antihistaminics. But we observed that dapsone has dose dependent relationship with acropustulosis of infancy.
Anti-Bacterial Agents ; Bacteria ; Biopsy ; Dapsone ; Extremities ; Female ; Fingers ; Fungi ; Humans ; Infant ; Neutrophils ; Skin ; Skin Diseases

Wide resection is an acceptable alternative to amputation for the management of primary sarcomas of the long bones or pelvis. The resected bone can be debrided of gross tumor tissue, autoclaved, and than replaced to reconstruct the limb anatomically. The procedure can be combined with prosthetic reconstruction of adjacent joints with sufficient strength to allow early unprotected weight-bearing. We had an experience of a large segmental defect in the shaft of the humerus after wide resection due to.a low grade malignant chondrosarcoma without extension to the surrounding soft tissues and this case had been managed by reimplantation after autoclaving the locally resected segment and autogenous iliac bone graft with a sound union and the favorable functional outcomes. So we are reporting this case with bibliographic reviews as a possible method of reconstruction for the management of the segmental defect which was produced by a local resection for a low grade malignancy.
Amputation ; Chondrosarcoma ; Extremities ; Humerus ; Joints ; Methods ; Pelvis ; Replantation ; Sarcoma ; Transplants ; Weight-Bearing

PURPOSE: The aim of this study was to analyze the osteogenic effect of cultured rabbit mesenchymal stem cells(MSCs). MATERIALS AND METHODS: MSCs were obtained from rabbit femur and were cultured in a Dulbecco's Modified Eagle's Medium(DMEM) with beta-glycerophosphatate, L-ascorbic acid, and dexamethasone to proliferate and differentiate into osteoprogenitor cells until 12 weeks. The expression of osteogenic markers was detected by reverse transcription-polymerase chain reaction(RT-PCR) and the release of osteocalcin was measured by Enzyme-linked Immunosorbent Assay(ELISA). MSCs that were cultured on the porous poly-L-lactic-co-glycolic acid(PLGA) scaffold were implanted into athymic nude mouse to observe the osteogenic activity. RESULTS: As the time, we observed osteoblastic-like cells on the culture flask. Mineralized nodules were observed at 3-4 weeks. Osteogenic markers such as osteopontin, osteonectin, type I collagen, and alkaline phophatase were all identified at 2 weeks. But, expression of osteocalcin was only detected after cells differentiation. The amount of osteocalcin which is a specific protein in osteoblast, increased gradually from 2 weeks until 7 weeks. Scanning electron microscopy revealed that the MSCs were well adhered and proliferated within the PLGA scaffold. Immature bone was identified after 10 weeks in the histological examination of transplanted cell-scaffold composit. CONCLUSION: Our results demonstrate gradual differentiation of MSCs into osteoblastic cells. The adhesion and proliferation of the cells within the biodegradable scaffold represents the possibility of bone formation using cell-scaffold composites.
Animals ; Ascorbic Acid ; Bone Marrow* ; Collagen Type I ; Dexamethasone ; Femur ; Mesenchymal Stromal Cells* ; Mice ; Mice, Nude ; Microscopy, Electron, Scanning ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Osteonectin ; Osteopontin

We have recently experienced with 3 cases of bilateral lung volume reduction surgery (LVRS) in patients with severe emphysematous disease in an effort to improve pulmonary mechanics. We compared intraoperative total dynamic lung compliance (CT) and % of breath exhaled in one second (V1.0%) obtained immediately pre-lung reduction and immediate post-lung reduction. In addition we also compared preoperative pulmonary function test (PFT) [FEV1, TLC, TG (trapped gas) and FRC] with 3 month postoperative values. Two of the three patients demonstrated post-reduction improvement in dynamic CT while only one patient demonstrated post-reduction improvement in V1.0%. All three patients demonstrated an increase in FEV1 and a decrease in TLC, TG and FRC with the greatest change in one patient who also had a significant reduction in CT and an improvement in V1.0% intraoperatively, and post-lung reduction. Although our results of the 3 cases are preliminary, it appears that side stream spirometry with immediate intraoperative measurement of dynamic CT and V1.0% could play a role in predicting expected follow-up objective pulmonary function tests; improvement in both CT and V1.0% may predict significant improvements in PFT.
Emphysema* ; Follow-Up Studies ; Humans ; Lung Compliance ; Lung* ; Mechanics ; Pneumonectomy* ; Respiratory Function Tests ; Rivers ; Spirometry

We have recently managed a patient, 31-year-old male, who has been in the state of inferior paraparesis due to cervical disc herniation. The centrally herniated disc material was removed through the posterior approach to the lesion under the general anesthesia in left lateral position. Two days after the operation with removal of herniated disc at C5-6interspace, the subject developed quadriparesis and difficulty in urination in which the weakness of upper extremities were more severe that of the lower extremities. The signs developed postoperatively were very much compatible with those of central cord syndrome, There was improving after the removal of the hematoma and of additional herniated material at second operation which was forced to be done due to development of central cord syndrome in severe degree following the primary surgery. Recovery from neurological dysfunction in order of good and better improvement was of leg, arm, voiding and finger.
Adult ; Anesthesia, General ; Arm ; Central Cord Syndrome* ; Fingers ; Hematoma ; Humans ; Intervertebral Disc Displacement ; Leg ; Lower Extremity ; Male ; Paraparesis ; Quadriplegia ; Upper Extremity ; Urination