The CD8(+)CD28(+) T cells have known to mediate major histocompatibility complex class I-restricted cytolysis and to secret an HIV-1 inhibitory factor. As HIV infection lead to dramatic changes within the cellular immune system, the cellular cytotoxicities decrease in the duration of the HIV infection. To determine the importance of the cellular cytotoxicities in long-term nonprogression, we tried to compare CD28 expression on total T, CD4(+) T, and CD8(+) T cells as one of methods for cellular cytotoxicity measurements between long-term nonprogressor and normal person or between long-term nonprogressor and rapid progressor. The median percentages and counts of CD4(+) T cells of the norrnal, the long-term nonprogressor, and the rapid progressor groups were 39.9 and 0.96 * 10(9) cells/L, 24.6 and 0.58 * 10(9) cells/L, 9.9 and 0.15 * 10 cells/L, respectively. As a result of comparison of the cells having CD28 surface molecules on CD8(+) T cells in the long-term nonprogressor and the rapid progressor group, they showed over 5 times lower than that in the normal group. Especially, the long-term nonprogressor regarded to the healthy HIV-infected patient showed much lower CD28 expression on total T, CD4(+) T, and CD8(+) T cells than those of the normal person. The proportions of CD4'CD28 T and CD3CD28 T cell subsets showed the significant difference between the LTNP and the RP group. In conclusion, although HIV-infected patients were LTNPs having the steady CD4(+) T cell counts and no clinical symptoms, we suggested that HIV led to abnormality within the lymphocyte subsets such as the altered expression of CD28 molecules on various T cell subsets and this result would cause deficiency of host immune function and failure of control of HIV replication by anergy in T cell subsets.
Cell Count ; HIV ; HIV Infections ; HIV-1 ; Humans ; Immune System ; Lymphocyte Subsets ; Major Histocompatibility Complex ; T-Lymphocyte Subsets* ; T-Lymphocytes

No abstract available.
Animals ; Colloids* ; Mice*

No abstract available.

Cancer remains one of the leading causes of mortality worldwide and poses a major threat to public health. Cancer incidence and death rates have increased in most countries since 1990. Therefore, the importance of systematic measures within the public health system, such as special hospitals for cancer patients, has been emphasized. Korea has established a 10-year plan to treat cancer patients and has implemented national cancer control policies (the 10-Year Plan for National Cancer Control) over the past 20 years, and these policies have resulted in dramatic breakthroughs in cancer survival. However, by focusing on the visible outcomes of cancer control, these policies have not shown adequate results in terms of building an integrated support system to improve the quality of life of cancer survivors or terminal cancer patients. In the future, the government should strive to build a comprehensive cancer management system that incorporates multipurpose integrated support measures, such as multidisciplinary, palliative, and hospice care.
Cancer Care Facilities ; Hospice Care ; Hospitals, Special ; Humans ; Incidence ; Korea* ; Mortality ; Palliative Care ; Public Health ; Quality of Life ; Survivors

No abstract available.
Spine*

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*

PURPOSE: To evaluate the negative pressure wound therapy for traumatic soft tissue defects by vacuum-assised closure (V.A.C.(R)). MATERIALS AND METHODS: 33 patients with traumatic soft tissue defects were treated by using V.A.C.(R) which removes edema fluid, eliminates an extrinsic cause of microcirculatory embarrassment and may directly stimulate cellular proliferation of reparative granulation tissue. We removed all necrotic tissue prior to application of the V.A.C.(R). The foam dressing was placed into direct contact with wound and was changed every 48~72 hours. The setting for vacuum pump was continuous pressure of 100 to 125 mm Hg. C-reactive protein was checked to evaluate wound infection. We measured wound size and total duration of treatment. RESULTS: Mean duration of treatment was 25.2 days and mean decrease of wound size was 31.9%. The concentration of CRP after V.A.C.(R) therapy reduced by day 8 below 1.0 mg/dl and gradually decreased to normal level by day 10. All patients showed hastened wound healing by rapid formation of granulation tissue. CONCLUSION: Negative pressure wound therapy is useful in patients with traumatic soft tissue defects, which reduces treatment duration and cost by rapid wound healing and effective infection control.
Bandages ; C-Reactive Protein ; Cell Proliferation ; Edema ; Granulation Tissue ; Humans ; Infection Control ; Negative-Pressure Wound Therapy* ; Vacuum ; Wound Healing ; Wound Infection ; Wounds and Injuries

Exercise is one of the most ubiquitous triggers of acute bouts of asthma. Late asthmatic responses(LARs) have been described following strenuous exercise, as in allergen-induced asthma. However, most studies have reported that airway responsiveness is not increased after exercise, even in subjects with LAR to exercise. This suggests that LAR after exercise may not be associated with inflammatory changes in the airways. We have frequently seen asthmatic children whose complaint is that symptoms are exacerbated at night after strenuous daytime exercise. Furthermore, airway responsiveness to allergen was reported to increase after LAR to exercise. Therefore, it is crucial to know whether exercise can induce airway inflammation, as in allergen-induced asthma. As an indirect measure to investigate it, we measured the activation status of eosinophil granulocyte in the peripheral blood during the early and late phase of exercise- or allergen-induced asthma. Eight subjects who showed early asthmatic response(EAR) and LAR(group 1), or EAR only (group 2) to allergen (Dermatophagoides pteronyssinus) challenge were selected. Similarly eight subjects who showed EAR and LAR(group 3), or EAR only (group 4) to exercise were selected. Blood samples were drawn at baseline, the early phase, the late phase, and 24 hours after each stimuli. Eosinofphil cationic protein (ECP) was measured in the serum. Eosinophil granulocytes were separated and the production of leukotriene C4 (LTC4) from purified eosinophfis was measured after stimulation with the calciumionophore. Serum levels of ECP were unchanged at EAR after allergen or exercise challenge. In the dual responder to allergen (group 1), serum ECP level was elevated at LAR and 24 hours after allergen challenge, as compared with the baseline level. On the other hand, in the dual responder to exercise (group 3), it remained unaltered up to 24 hours after exercise challenge. Eosinophils at EAR after allergen or exercise challenge in each group generated the similar amounts of LTC4 as baseline values. In group 1, the production of LTC4 was slightly increased though not significantly at LAR, and significantly increased 24 hours after allergen challenge. In group 3, it was increased significantly at LAR, but restored to the baseline values at 24 hours after exercise challenge. These results indicate that not only allergen but also exercise can activate eosinophils in accordance with LAR. The present findings suggest that LAR to exercise may also have the potential to induce airway eosinophilic inflammation although its duration may be shorter than that of LAR to allergen. Therefore exercise should be understood not only as a triggering factor of bronchoconstriction but also as one that incites or deteriorates airway inflammation.
Asthma* ; Bronchoconstriction ; Child ; Ear ; Eosinophils* ; Granulocytes ; Hand ; Humans ; Inflammation ; Leukotriene C4

For 16 years after the finding of HIV as an agent of AIDS in 1981, HIV therapeutic drugs of reverse transcriptase inhibitors (AZT, ddI, ddC, d4T) and protease inhibitors have been developed. Recent studies also were focused on a combination therapy by using HIV therapeutic drugs or natural compounds. Korean red ginseng (KRG) of natural compounds has been well known as a good reinforcement agent in Asia. The percentage of CD3+CD4+ T cell in nine HIV-infected patients without KRG treatment averaged 17.8% on baseline and decreased 15.8% after 6 months, whereas the percentage of the cell in fifteen HIV-infected patients with KRG treatment averaged 15.3% on baseline and increased up to 18.9% after the same period. The average percentage of CD3+CD8+ T cell of KRG-nontreated and KRG-treated HIV patients increased after 6 months 47.8% to 50.7% and 44.7% to 51.4%, respectively; and the average percentage of B and NK cell in the KRG-nontreated and KRG-treated HIV patients decreased 9.4% to 7.9% and 13.0% to 9.7%, 8.9% to 8.5% and 16.2% to 11.6%, respectively, KRG, therefore, didn't have any effects on the CD3+CD8+ T cell, B cell, and NK cell. However, it seems that KRG has a potential activity for stimulating the
Asia ; HIV ; Humans ; Killer Cells, Natural ; Lymphocyte Subsets* ; Lymphocytes* ; Panax* ; Protease Inhibitors ; Reverse Transcriptase Inhibitors

PURPOSE: To evaluate MRI findings of malignant ovarian tumors. MATERIALS AND METHODS: MRI findings were retrospectively reviewed in 25 patients with surgically confirmed 30 malignant ovarian tumors(common epithelial tumor;23, sex cord stromal tumor;2, endodermal sinus tumor ; 1, metastatic tumor ;4). The findings evaluated were the lesion size, solid and/or cystic component, wall thickness, septal thickness, necrosis, invasion of adjacent organ, ascites, and adenopathy. RESULTS: MRI findings of the malignant ovarian tumors were as follow:Size of lesion was 5-35cm(mean 14cm) ;solid component was present in 80%(24/30);wall thickness was more than 3ram in 90%(27/30);septal thickness was more than 3ram in 70%(21/30);tumor necrosis was present in 40%(12/30%) ;invasion of adjacent organ was present in 76%(19/25);ascites was present in 56%(14/25);lymphadenopathy was present in 24% (6/25). MRI findings of absence of solid component(6/6), even wall and septal thickness(7/7, 19/19) were found only in epithelial tumors. Uneven septal thickness more than 3mm(7/11) was a predominant MRI findings of non-epithelial tumors. Well-defined cystic lesion within solid component was seen in Krukenberg tumors. CONCLUSION: Evaluation of the lesion size, internal architecture, invasion of adjacent organ, ascites, and lymphadenopathy in MRI would enable diagnosis of malignant ovarian tumors and could lead to possible differential diagnosis of epithelial tumors from non-epithelial tumors.
Ascites ; Diagnosis ; Diagnosis, Differential ; Endodermal Sinus Tumor ; Humans ; Krukenberg Tumor ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Necrosis ; Retrospective Studies