No abstract available.
Arthritis, Rheumatoid* ; Humans

No abstract available.
Tenosynovitis*

PACS (Picture Archiving and Communications System) is a computer-based image storage and retrieval system that can store, recall and display medical images rapidly on high resolution workstations. The image acquisition system consists of direct digital interface to computed radiography (CR) system. We reviewed X-rays of 84 patients who had both studies of Dual energy X-ray Absorptiometry (DXA) and AP, lateral views of lumbar vertebrae between January and December of 1995. We tried to verify the clinical implication of pixel values on PACS for DXA by comparing pixel values and bone mineral density (BMD) of the 2nd, 3rd and 4th lumbar vertebrae. They were all female between 44 and 72 years old, average age of 59. Bone mineral density (BMD), represented in DXA of a total of 252 vertebrae were mostly in the range of between 0.228 (22%) and 1.318 (121%). Pixel values of the AP and lateral views of the 2nd, 3rd and 4th vertebrae in the PACS workstation were closely correlated to bone mineral density (p=0.0001). The values of the DXA (bone mineral density and T score) get comparatively lower as the pixel values get smaller. In conclusion, the pixel value on PACS interfaced to CR could be utilized as an easy, speedy and economical tool for screening of osteoporosis.
Absorptiometry, Photon* ; Aged ; Bone Density ; Female ; Humans ; Lumbar Vertebrae ; Mass Screening ; Osteoporosis ; Radiography ; Spine

No abstract available.
Interleukin-4* ; Interleukins* ; Receptors, Interleukin-4* ; Rheumatic Diseases*

BACKGROUND: To determine the molecular structure of type II collagen-specific T-cell receptors associated with rheumatoid arthritis (RA). METHODS: We generated CII-specific T-cell lines of 8 RA patient s by prolonged in vitro culture with bovine CII (bCII) and the immunogenic peptide (256-270) of human CII. The proliferation response towards CII stimulation was measured from the uptake of 3 H-thymidine. Changes in the secretion of Th 1 and Th2 cytokines in the culture supernatent were measured by ELISA. The TCR clonotypes of these T-cells were examined by RT-PCR/ SSCP analyses of all 22 V beta chains. RESULTS: T-cells from patients' tissue exhibited strong proliferation index upon CII stimulation, which was maintained up to 6 months in the culture. The secretion of INF-gamma from these T-cells increased along with the duration of culture time, while the amount of IL-4 production did not show significant changes. The SSCP band patterns of patients' T-cells appear as discrete bands unlike the smeary streak produced from normal samples. Some SSCP bands, each representing selected expansion of a TCR containing certain subtype of V beta peptides, appeared to be identical in more than one patients. Among these, the expansion of SSCP band representing the V beta 14 CDR3 region persisted after switching the antigen to the immunogenic human peptide (256-270). CONCLUSION: CII-reactive T-cells expressing distinct CDR3 motifs are selectively expanded in the peripheral blood and synovial fluid of RA patients, and their persistent proliferation upon CII stimulation, as well as the production Th 1-type cytokines, may play pivotal roles in RA pathogenesis.
Arthritis, Rheumatoid* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-4 ; Molecular Structure ; Peptides ; Polymorphism, Single-Stranded Conformational ; Receptors, Antigen, T-Cell ; Synovial Fluid ; T-Lymphocytes*

No abstract available.
Dermatitis, Allergic Contact

Papillary and solid epithelial neoplasm is a rare pancreatic tumor of low-grade malignancy. We report a case of a 23 year old female having solid and papillary neoplasm of the pancreatic tail with mutiple omental and peritoneal metastases. Microscopically, the main tumor showed typical histologic findings including solid and papillary areas with cystic change. But the metastasizing nodules were largely solid and the tumor cells demonstrated increased nuclear pleomorphism, hyperchromasia and an increased mitotic rate. The tumor cells contained considerable amount of intracellular and extracellular eosinophilic inclusions which were ultrastructually zymogen-like granules. These inclusions were more frequently found in the metastatic nodules. By flow cytometric study, the tumor was hyperdiploid. The DNA index was not significant.
Female ; Humans ; Neoplasm Metastasis

BACKGROUND: Tumor necrosis factor(TNF)-alpha and Interleukin(IL)-1beta are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-alpha in the pathogenesis of ARDS, including human studies, it has been reported that TNF-alpha is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-alpha and IL-lbeta as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. METHODS: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood sample were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-alpha and IL-lbeta was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. RESULTS: 1) Plama TNF-alpha levels: Plasma TNF-beta levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the mean+/-2SD, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-alpha levels from patients with ARDS were 10.26pg/mL(median;<10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-alpha levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (P<0.01). There was no statistical significance between survivors(< 10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-alpha levels. 2) Plasma IL-lbeta levels: Plasma IL-1beta levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-1beta levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ng/mL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-19 levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). CONCLUSION: Plasma TNF-alpha and IL-1beta level are not a predictable marker for development of ARDS. But TNF-alpha is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-alpha and IL-1beta in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.
Acute Lung Injury ; Adult* ; Chungcheongnam-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intensive Care Units ; Interleukin-1beta* ; Lung ; Lymphotoxin-alpha ; Necrosis ; Plasma ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Shock ; Shock, Septic ; Tumor Necrosis Factor-alpha*

No Abstract available.
Ankle* ; Sarcoidosis* ; Tenosynovitis*

OBJECTIVE: To investigate the correlation between the motor evoked potentials (MEPs) amplitude of 1st dorsal interosseus in affected limbs and affected hand function after stroke. METHOD: We enrolled 109 patients with acute and subacute 1st attack stroke. Transcranial magnetic stimulation (TMS) was applied to the motor cortex and MEP was recorded at the 1st dorsal interossei (DI) muscle. MEP parameters were latency of the affected side, latency ratio (latency of affected side/latency of unaffected side), amplitude of affected side and amplitude ratio (amplitude of affected side/latency of unaffected side). Hand function tests (HFT) including hand power measures and a nine hole peg test (NHPT) were conducted and the ratios of the value of the affected hand to unaffected hand were used for the analysis. The Korean version of the modified Barthel index (K-MBI) and the manual muscle test (MMT) of finger flexion were also evaluated. Correlation between MEP parameters and the clinical variables such as HFT, K-MBI and MMT grades were analyzed. RESULTS: While MEPs in the affected 1st DI were recorded in fifty six patients, MEPs were not recorded in forty nine patients. The responsiveness of MEPs was significantly correlated with the HFT, K-MBI and MMT grades. The amplitude ratio had the most significant correlation with the HFT and MMT grade in this MEP study. Also, the amplitude ratio had more significant correlations with the K-MBI score compared with other MEP parameters. CONCLUSION: We concluded that the amplitude ratio may be a useful MEPs parameter for indicating hand function.
Evoked Potentials, Motor ; Extremities ; Fingers ; Hand ; Humans ; Motor Cortex ; Muscles ; Organometallic Compounds ; Stroke ; Transcranial Magnetic Stimulation