No abstract available.

No abstract available.
Hip ; Humans ; Venous Thromboembolism

There are strong evidences suggesting that Thl and Th2 lymphocytes develop from the same Thlymphocyte precursor under the influence of environmental or genetic factors acting at the level of antigen presentation, but it remains to be answered whether it is possible to change the cytokine profile of established or ongoing Th1 and Th2 response. The purpose of this study is to reveal whether it is possible to reverse the cytokine profile of human Th lymphocytes by the modulation of antigen presentation. Using a multiparameter flow cytometric assay that allows simultaneous determination of surface CD4 and intracellular IFN-r or IL-4, we have studied the emergence of Th1 or Th2 lymphocytes in response to tetanus toxoid exposure and the patterns of cytokine synthesis in established T lymphocyte clones. Th2 populations arising after 4 wk of stimulation in IL-2, PHA, tetanus toxoid and irradiated autogeneic peripheral blood mononuclear cells as antigen presenting cells (APC) could give rise to IFN-r-producing Th1 lymphocytes when stimulated in IL-2 plus PHA in the absence of antigen and APC. These IFN-r-producing Th1 lymphocytes nearly disappeared and IL-4-producing Th2 lymphocytes predominated again when cultured again in the presence of antigen and APC. In contrast, prolonged culture in the absence of antigen and APC induced relative predominance of IFN-r-producing The lymphocytes. The cytokine profile of long-term Th2 population arising originally from the repeated stimulation in the presence of antigen and APC appeared more homogeneous and less reversible, although they could convert to Th1 lymphocytes when cultured without antigen and APC. These findings may explain that the polarized Th response is reversible depending on the presence of antigen presentation.
Antigen Presentation* ; Antigen-Presenting Cells ; Clone Cells ; Humans ; Interleukin-2 ; Interleukin-4 ; Lymphocytes ; T-Lymphocytes, Helper-Inducer* ; Tetanus Toxoid

No abstract available.

BACKGROUNDS : Infections due to vancomycin-resistant enterococci (VRE) have been reported with increasing frequency in many parts of the world. However, VRE infection is still very rare in Korea. To assess the potential risk of VRE infection in a hospital where such infection is rarely reported, we screened hospitalized patients for fecal colonization with VRE and performed a clinical and epidemiological investigation of VRE colonization. MATERIALS AND METHODS: We screened 405 stool specimens from in- and outpatients for the presence of enterococci using EnterococcoselTM agar (BBLR, USA). Dark-brown or black colonies were tested for enterococci and speciated, followed by confirmation for vancomycin resistance using brain-heart infusion agar containing vancomycin (6microgram/mL). Antimicrobial susceptibilities were determined by agar dilution, disk diffusion, and Vitek GPS-IZ. We also performed pulsed-field gel electrophoresis (PFGE) after SmaI digestion of DNA and polymerase chain reaction for detection of vanA, B and C. To define risk factors for colonization, we reviewed the medical records of patients colonized with VRE or vancomycin- susceptible enterococci (VSE). RESULTS: Twelve (4.1%) of 295 hospitalized patients were colonized with VRE. Six were identified as Enterococcus(E) faecium, 2 each as E. faecalis and E. gallinarum, and 1 each as E. casseliflavus and E. avium. In contrast, only one(0.9%) VRB (E. casseliflavus) was isolated from outpatients. Patients in the intensive careunit (5.4%) and patients whose stool specimens were submitted for Clostridium difficile toxin assay (6.8%) were colonized at higher rate than other inpatients (2.5%), but not at a statistically significant level. Three strains had high-level resistance to van comycin(minimum inhibitory concentration, MIC>256microgram/mL), and the others had low-level resistance (MIC8-16microgram/mL) by agar dilution. But disk diffusion method and Vitek system had problems in detecting some strains with low-level resistance. PFGE patterns of VRE were diverse, suggesting that VRE have been introduced from multiple sources. The vans gene was detected in 3 isolates and vanC gene was found in 9 isolates. Compared with the patients with VSE colonization, patients with VRE had a significantly longer hospital stay, had more frequent invasive procedures or therapeutic interventions such as ventilator, total parenteral nutrition and hemodialysis, showed renal insufficiency more frequently, and were more likely to have received ciprofloxacin or clindamycin therapy. CONCLUSIONS: Although the incidence of VRE infection remains low in Korea, the findings from this study indicate that VRE are not uncommon intestinal colonizers among hospitalized patients. Strict infection control measures including screening for VRE, especially those from patients at risk, close surveillance, judicious use of antibiotics and patient isolation must be implemented to prevent infection and transmission of VRE.
Agar ; Anti-Bacterial Agents ; Ciprofloxacin ; Clindamycin ; Clostridium difficile ; Colon* ; Diffusion ; Digestion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Incidence ; Infection Control ; Inpatients ; Korea ; Length of Stay ; Mass Screening ; Medical Records ; Outpatients ; Parenteral Nutrition, Total ; Patient Isolation ; Polymerase Chain Reaction ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Vancomycin ; Vancomycin Resistance ; Ventilators, Mechanical

BACKGROUNDS : Infections due to vancomycin-resistant enterococci (VRE) have been reported with increasing frequency in many parts of the world. However, VRE infection is still very rare in Korea. To assess the potential risk of VRE infection in a hospital where such infection is rarely reported, we screened hospitalized patients for fecal colonization with VRE and performed a clinical and epidemiological investigation of VRE colonization. MATERIALS AND METHODS: We screened 405 stool specimens from in- and outpatients for the presence of enterococci using EnterococcoselTM agar (BBLR, USA). Dark-brown or black colonies were tested for enterococci and speciated, followed by confirmation for vancomycin resistance using brain-heart infusion agar containing vancomycin (6microgram/mL). Antimicrobial susceptibilities were determined by agar dilution, disk diffusion, and Vitek GPS-IZ. We also performed pulsed-field gel electrophoresis (PFGE) after SmaI digestion of DNA and polymerase chain reaction for detection of vanA, B and C. To define risk factors for colonization, we reviewed the medical records of patients colonized with VRE or vancomycin- susceptible enterococci (VSE). RESULTS: Twelve (4.1%) of 295 hospitalized patients were colonized with VRE. Six were identified as Enterococcus(E) faecium, 2 each as E. faecalis and E. gallinarum, and 1 each as E. casseliflavus and E. avium. In contrast, only one(0.9%) VRB (E. casseliflavus) was isolated from outpatients. Patients in the intensive careunit (5.4%) and patients whose stool specimens were submitted for Clostridium difficile toxin assay (6.8%) were colonized at higher rate than other inpatients (2.5%), but not at a statistically significant level. Three strains had high-level resistance to van comycin(minimum inhibitory concentration, MIC>256microgram/mL), and the others had low-level resistance (MIC8-16microgram/mL) by agar dilution. But disk diffusion method and Vitek system had problems in detecting some strains with low-level resistance. PFGE patterns of VRE were diverse, suggesting that VRE have been introduced from multiple sources. The vans gene was detected in 3 isolates and vanC gene was found in 9 isolates. Compared with the patients with VSE colonization, patients with VRE had a significantly longer hospital stay, had more frequent invasive procedures or therapeutic interventions such as ventilator, total parenteral nutrition and hemodialysis, showed renal insufficiency more frequently, and were more likely to have received ciprofloxacin or clindamycin therapy. CONCLUSIONS: Although the incidence of VRE infection remains low in Korea, the findings from this study indicate that VRE are not uncommon intestinal colonizers among hospitalized patients. Strict infection control measures including screening for VRE, especially those from patients at risk, close surveillance, judicious use of antibiotics and patient isolation must be implemented to prevent infection and transmission of VRE.
Agar ; Anti-Bacterial Agents ; Ciprofloxacin ; Clindamycin ; Clostridium difficile ; Colon* ; Diffusion ; Digestion ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Incidence ; Infection Control ; Inpatients ; Korea ; Length of Stay ; Mass Screening ; Medical Records ; Outpatients ; Parenteral Nutrition, Total ; Patient Isolation ; Polymerase Chain Reaction ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Vancomycin ; Vancomycin Resistance ; Ventilators, Mechanical

BACKGROUND: The Ingram regimen has been advocated for t.he treatment of psoriasis. It is an effective therapeutic moiality, but its complexity and frequent side reactions have restricted its use for therapy. There are several modified Ingrarn regimen, change of vehicle, shortening of application time, low-strerigth anthralin, combination with emollient. Previously, we have reportved the effectiveness of mocified Ingram regimen for psoriasis, however, the remission time and relapse rate of psoriasis has not been reported in Korea. OBJECTIVE: This study was performed to evaluate the efficacy of the modified Ingram region for the treatment of psoiasis and the remission time and relapse rate of psoriasis following moclified Ingram therapy. METHODS: Sixty patients with plaque-form psoriasis were treated with the modified Ingra,n therapeutic regimen. They were divided into two groups, a moderate group which included 39 patients, and 21 patients in a severe group. RESULTS: The follwing results were obtained from this study. 1. Among 60 patients, 52 patients(86.6%) were successfully healed and 8 patients(13.3%) showed failure in their t eatment. 2. In 52 patients, 44 patients(73.3%) showed a clearing of psoriasis, 8 patients(13.3%) showed some improvement. 3. In 44 cleared patients mean numbers and duration of therapy reaching grade 4 were 13.0 and 21.0 days for the trunk and 15.1 and 24.7 days for the extremities, the difference was not significant statistically(p>0.05). The difference between the total dose in trunk and extremitis was significant statistica,ly(p<0.05). 4. In 44 cleared patients mean numbers, duration and total dose of therapy reaching grade 4 in the severe group were significantly higher than those in the moderate group (p<0.05). 5. There were some rotable side effects such as staining(17.3%), erythema(15.4%) and pruitus(13.5%), but in no case therapy was terminated. 6. According to the everity in 33 of the cleared patients, we observed 10 patients(17.4%) with early relapse((6 months), 7(21.7%) with late relapse(>6 months) and 14(60.9%) with riorelapse(>12 months) in the moderate group and also observed 10 patients(70.0%) with early IP, lapse, 2(20.0%) with latrelapse and 1(10.0%) with no relapse in the severe group. 7. In 33 pat,ients who were followed up at least one year later, the mean time of remission was 31.4 months in the moderate group and 6.0 mont,hs in the severe group. There were signilicant differences in the two groups(p<0.05). CONCLUSION: The results of this study suggest that the modified Ingram regimen is one of the effective therapeutic mocialities for cases of moderate psoriasis.
Anthralin ; Extremities ; Humans ; Korea ; Psoriasis* ; Recurrence

No abstract available.

No abstract available.

The acetabular angles were measured in 2 groups of selected 100 infants and children each, of whom one group aged 14 months and younger and the other group aged 15 months of 5 yrs. and who were proved to be normal by all the physical examination and whose acetabular angles were below 40 according to Coleman's diagnostic criteria. The measurements were broken down into right and left, and male and female because of the known difference in the incidence of CDH in 2 members of each of these paired categories and analysed statistically. The following statistic significances resulted: l. All the measured normal acetabular angles vary between 10 and 31 degrees. 2. The acetabular angles decrease after weight bearing by the statistical significant difference between 0-14 mo. group and 15 mo-5yr. group. The angles are 22,61±3,47 (M±S,D) and 18.68±3.64 (M±S.D) respectively. 3. The acetabular angles of female of 15mo.-5yr. group are higher than male by the statistical significant difference. The angles are 17.77±3.54 (M±S.D) and 20.18±3.29 (M±S.D) respectively. 4. Statistical significant differences were absent between right and left.
Acetabulum ; Child ; Female ; Humans ; Incidence ; Infant ; Male ; Physical Examination ; Weight-Bearing