Cytotoxic T lymphocytes (CTL) playing an important role in e cell-mediated immune response kill the target cells by the special contact-dependent mechanism. It has been known that CTL and NK cells utilize two different pathways in removing specific target cells: apoptotic cell death and osmotic lysis by the pore forming protein. Interaction of CTL with target cells results in the ligand-induced, receptor-mediated, nonsecretory lytic process and lethal hit is delivered by the transducing molecule, Fas (CD95, APO-1), one of the TNFR/NGFR superfamily. In addition, ligation of TNF receptor and CD40 also induced the apoptosis of B cell and epithelial cells. However, recognition of target cells, the triggering mechanism, cytotoxic mediators, internal metabolic pathway and signal transduction behind apoptosis remain undefined and have been elucidated only in part. ...continue...
Apoptosis* ; Cell Death ; Epithelial Cells ; Genistein ; Ice ; Killer Cells, Natural ; Ligation ; Metabolic Networks and Pathways ; Receptors, Tumor Necrosis Factor ; Signal Transduction ; T-Lymphocytes, Cytotoxic*

No abstract available.
Empyema*

To Evaluate the clinical characteristics of childhood-onset systemic lupus erythemoatosus (SLE) and analyse the factors related to outcome of renal function in lupus nephritis, we reviewed medical records of 18 cases of SLF diagnosed at the Department of Pediatrics. Pusan National University Hospital from January 1981 to December 1990. The results were as follow: 1)Male to female ratio was 1:2.6. 2) Nephropathy was the most common initial impression, and 8 cases were diagnosed as SLE at first. 3) The clinical menifestation. was ANA (+), malar rash, renal disorder, hematologic disorder in frequency. 4) Diffuse proliferative lupus nephritis was the most common in renal histopathologic studies. 5) Among the follow-up cases, active lupus was 39%, remission was 28%. 6) As factors related to outcome of lupus nephrits were, hypertension and proteinuria were siginificant statistically.
Busan ; Exanthema ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Medical Records ; Pediatrics ; Proteinuria

Lymphomatoid papulosis(LyP) is a chronic recurrent dermatosi characterized by involuting and recurring papules, plaques, and nodules showing histologic feaurs suggesting rnalignant lymphoma. On histologic ground, it is divided into two types. type A and type B. In type A, large atypical lymphocytes are the main cellular cornponent and most of these express CD 30(Ki-1) antigen, which has been p!reviously thought to be specific for Read Sternberg cells of Hodgkins disease. In type B, cerebriform mononuclear lymphocytes sirr la to those in mycosis fungoides predominates. We report two cases of lymphomatoid papulosis, type A and type B, respectively. The large atypical cells in type A LyP expressed Ki 1 antigen. Both case were treated with PUVA and the outcome of the treatment has been fair.
Antigens, CD30 ; Hodgkin Disease ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis ; Mycosis Fungoides

No abstract available.
Pulmonary Aspergillosis*

Eosinophilic fasciitis is a syndrome which is characterized by scleroderma-like skin involvement, eosinophilia and hypergammaglobulinemia without significant systemic changes. The primary pathological alterations are thickening and inflammation of the deep fascia. The majority of the cases that have been reportecd respond to systemic corticosteroids. We describe a 19-year-old male patient with eosinophilic fasciitis. On physical examination, he showed tender, edematous, indurated and tight skin in the back and both lower legs, and the laboratory findings showed eosinophilia and mild hypergammaglobulinemia. He also had Raynaud phenomenon, mild dyspnea, abdominal pain, pulmonary function abnormalities and roentgenographic evidence of pulmonary fibrosis. Result of a biopsy showed sclerosis of dermia and intense infiltrations of eosinophils, lymphocytes and histiocytes and fibroais of panniculus and fascia. Treatment with systemic corticosteroids showed complete resolution of the skin lesions, but after withdrawal new scleroderma-like skin lesions developed in the dorsum of feet.
Abdominal Pain ; Adrenal Cortex Hormones ; Biopsy ; Dyspnea ; Eosinophilia ; Eosinophils ; Fascia ; Fasciitis* ; Foot ; Histiocytes ; Humans ; Hypergammaglobulinemia ; Inflammation ; Leg ; Lymphocytes ; Male ; Physical Examination ; Pulmonary Fibrosis ; Raynaud Disease ; Sclerosis ; Skin ; Young Adult

We report a case of inflammatory linear verrucous epidermal nevus which was treated with an aromatic analog of vitamin A acid, Ro 10-9359, with significant effect, The patient is a 17-year-old woman who has had linear verrucous patches involving the entire length of the extensor surface of the right arm, right scapular area and anterior upper part of the right chest with persistent itching sensation of 10 years' duration. The patient was treated with oral Ro 10-9359 75mg daily, and showed marked improvement of the skin lesions after seven days of treatment, but the patient was lost to follow up.
Adolescent ; Arm ; Etretinate ; Female ; Humans ; Lost to Follow-Up ; Nevus, Sebaceous of Jadassohn* ; Pruritus ; Sensation ; Skin ; Thorax ; Tretinoin

No abstract available.
Uterus*

Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.
Aspergillosis ; Autopsy ; Biopsy* ; Candidiasis ; Cytomegalovirus ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; In Situ Hybridization ; Liver Transplantation ; Liver* ; Lymphoproliferative Disorders ; Mortality ; Primary Graft Dysfunction ; Prognosis ; Thrombosis ; Tissue Donors ; Transplants

BACKGROUND: To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital. METHODS: We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL. RESULTS: Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups. CONCLUSIONS: Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.
APACHE ; Body Mass Index ; Calcitriol ; Chronic Disease ; Critical Care ; Critical Illness* ; Humans ; Intensive Care Units ; Mortality ; Prevalence* ; Respiration, Artificial ; Retrospective Studies ; Tertiary Healthcare ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*