In 1932, Harris, et al., reported that vitamin A had an anti-keratinizing effect on acne vulgaris, and in 1948, Straumfjord, somewhat over-enthusiastically reported that oral use of vitamin A also had a beneficial effect on acne. In spite of studies by Lynch and Cook (1947), and Andrew and Stokoe (1963), which questioned its effectiveness, the original enthusiasm for this regimen has not been completely dampened. Kligman (1969) reported that vitamin A acid (VAA), a metabolic end-product of vitamin A metabolism, produced a peeling effect and when applied topical was effective in tbe treatment of acne. The mechanism of action of VAA is incompletely understood, however, it is observed to cause, arnong other things, an increase in the speed of proliferation of the cells of the epidermis; dissolution of the intracellular lysosomes; increase in the rate of keratin formation and the conversion of hard keratin to soft keratin; and an increase in the secretion of the sebaceous glands. The effect of VAA in acne treatment is due to the increase in the secretion of the sebaceous glands which prevents the formation of comedones. It is believed that the increased spced of cell division, increased keratinization and softening of the keratin cause a weakening of the intercellular adhesion. These processes cause an acceleration of the flow of cells out of the sebaceoua glands which prevents the formation of comed.ones and forces existing comedones to the surface of the skin. For this study, thirty eight patients with acne vulgaris were selected from among the outpatients of Severance Hospital. They were divided into two groups. The first group was treated with application of vitamin A acid alone. The second group was treated concurrently with topical vitamin A acid and oral tetracycline. The results were a.s folIows: l. The group treated for three weeks with VAA alone showed significant improvement in up to 70 of the cases. 2. The group treated with VAA and oral tetracycline showed results which were sirnilar to the group on VAA alone. 3. In both groups. closed cornedones and papules gradually disappeared, however, the number of open com.dones increased in the first week, but decreased threafter, In combined therapy, pustules disappeared grad.ually just like the papules, but in therapy with VAA alone, the number of pustules increased during tbe first week and decreasd. thereafter. 4. In the group which was treated with VAA alone, undesirable side effects such as scaling, erythema, tightness, itching and burning sensation were seen, and also occasionally fissures, edema, pain and oozing were noted. In the group treated with combined therapy, similar findings were recorded.
Acceleration ; Acne Vulgaris* ; Burns ; Cell Division ; Edema ; Epidermis ; Erythema ; Humans ; Lysosomes ; Metabolism ; Outpatients ; Pruritus ; Sebaceous Glands ; Sensation ; Skin ; Tetracycline ; Tretinoin* ; Vitamin A* ; Vitamins*

Cyclosporine(CsA) has been known to cause an endothelial dysfunction following its use as an immunosuppressive agent. On the other hand, the vascular endothelium has been recognized as an endocrine organ in its own right, i.e., it releases vasoactive factors such as nitric oxide(NO) and hyperpolarizing factor(EDHF). NO is synthesized by at least three isoforms of NO synthases(NOS), among which ecNOS is constitutively expressed in the endothelium. The principle of EDHF has not been determined. The present study was aimed at further investigating the mechanisms underlying the CsA-induced vasculopathy. Rats were treated with CsA (25mg/kg/day, subcutaneous) for one week and their thoracic aortae were isolated. Their changes of iso-metric tension in responses to acetylcholine, diazoxide, and high concentrations of calcium were recorded. The expression of ecNOS mRNA and protein was determined by reverse transcription-polymerase reaction and Western blot analysis, respectively. The acetylcholine-induced relaxation of the aortic rings was significantly diminished follawing the CsA-treatment, which was prevented by L-arginine supplemented along with the CsA-treatment. The relaxation of the thoracic aorta in response to either diazoxide or high concentrations of extracellular calcium was not affected by CsA-treatrnent. The vascular tissue contents of NO metabolites were significantly decreased following the CsA-treatment, which was also prevented by L-arginine-supple-mentation. Neither ecNOS mRNA nor protein expression was significantly altered following the CsA-treatment. It is suggested that CsA induces an endothelial dysfunction, which cannot be attributed to an altered role of EDHF, but to an impairment in L-arginine/NO pathway at the steps beyond NOS protein expression.
Acetylcholine ; Animals ; Aorta, Thoracic ; Arginine ; Blotting, Western ; Calcium ; Diazoxide ; Endothelium ; Endothelium, Vascular ; Hand ; Protein Isoforms ; Rats* ; Relaxation ; RNA, Messenger

BACKGROUND: The effects of intravenous thrombolytic therapy depend on maintaining the patency of infarct-related artery in acute myocardial infarction. Thirty-two patients with acute myocardial infarction and ST segment elevation were studied to determine the usefulness of early resolution of ST segment elevation as an index of recanalization after intravenous urokinase administration. METHOD: 32 patients(male 24, female 8, mean age+/-standard deviation 62+/-11 years) were given intravenous urokinase therapy for acute myocardial infarction. Patients were classified into two groups according to changes of Summation operator ST segment elevation : early resolution(group I)=resolution to <25% of peak value within 12 hours of commencing urokinase therapy : no resolution(group II)=decreased in Summation operator ST segment elevation to > or =25% of peak value. The relationship between early changes in Summation operator ST segment elevation, time to peak creatinine kinase(CK), peak CK, changes of QRS score and & stenosis of infarct-related artery were investigated in both group. RESULTS: 1) The Summation operator ST segment elevation decreased by more than 75% of initial Summation operator ST within 12 hours after urokinase administration in 13 patients(40.6%). 2) The initial Summation operator ST segment was higher in the early resolution group than in the nonresolution group(26.0+/-4.2 vs 15.2+/-1.9mm, p<0.05). 3) The initial QRS score in both groups were not different significantly(7.2+/-0.9 vs 5.4+/-0.6 p<0.05), but QRS score decreased in the early resolution group and did not change in the no resolution group(-0.69+/-0.23 vs 0.63+/-0.16, p<0.05). 4) The early resolution group showed higher peak CK level(2409.2+/-347.7 vs 1445.2+/-280.4, p<0.05) and earlier peak time(10.6+/-1.0 vs 24.2+/-4.6, p<0.05). 5) There was no total occluded artery in both group, but the early resolution group tended to less stenosis in infarct related arteries(66.7+/-80 vs 86.7+/-3.3%, p=0.13) in predischarge coronary angiography. CONCLUSIONS: Early ST resolution after intravenous urokinase administration in acute myocardial infarction is an useful clinical index of recanalization or benefit induced by thrombolytic therapy.
Arteries ; Constriction, Pathologic ; Coronary Angiography ; Creatinine ; Female ; Humans ; Myocardial Infarction* ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator*

Thirty-one Patients who underwent reoperation from Jan. 1983 to Dec. 1988. were analysed retrospectively. The results of reoperation showed the excellent recovery in 13 cases(42%) and good recovery in 12 cases(39%) in terms of pain relief and working capability. But 6 cases(19%) couldn't be managed successfully. The most common intraoperative findings were true recurrences(14 cases: 45%), missed disc material(7 cases: 23%), and small recurrent fragment embedded in epidural fibrosis(7 cases: 23%). The clinical result is affected predominantly by the intraoperative pathology and the time interval between the first and second operation. The excellent or good results could be achieved among patients with true recurrences occurred after more than 6 months following initial surgery and among the patients who were operated again within one month because of missed disc material, hematoma, and inadequate laminectomy and discectomy. But the patients who underwent reoperation between 1 month and 6 months because of a small recurrence and fibrosis or epidural fibrosis showed the poor results. The complete removal of disc, adequate bleeding control, adequate laminectomy were considered to be helpful to reduce the chance of reoperation. Microsurgery is advisable in reoperations because it can facilitate the dissection between fibrous scar and nerve root, making the small recurrent disc material removed completely.
Cicatrix ; Diskectomy ; Fibrosis ; Hematoma ; Hemorrhage ; Humans ; Laminectomy ; Microsurgery ; Pathology ; Recurrence ; Reoperation ; Retrospective Studies

No abstract available.
Echocardiography* ; Heart Ventricles* ; Tendons*

PURPOSE: This study was aimed to investigate the age related changes of lymphocyte subset values in healthy Korean children. METHODS: Eighty healthy children were divided into four groups: group A(less than 1yr, n=20), group B(from 1 to 211/12 yr, n=20), group C(from 3 to 511/12 yr, n=20), group D(more than 6 yr, n=20). Their blood were examined for the proportions of CD3+, CD4+, CD8+ and CD19+ lymphocytes utilizing monoclonal antibodies and flowcytometry. RESULTS: 1) The percentage of CD19+ lymphocytes was significantly decreased with age. 2) The percentage of CD3+ lymphocytes was relatively constant, irrespective of age. 3) The percentage of CD4+ lymphocytes was significantly decreased with age. 4) The percentage of CD8+ lymphocytes was increased with age, but the changes were not significant. 5) The ratio of CD4+/CD8+ cells was significantly decreased with age. 6) The absolute numbers of total lymphocytes, CD19+, CD3+, CD4+ and CD8+ lymphocytes were significantly decreased with age. CONCLUSIONS: In this study, as in previous other studies1-6), the results suggest that there are specific changes in proportions of lymphocyte subsets with age, independent of total lymphocyte count. There were similar trends of changes in many studies, but the reference ranges were somewhat differnt from one another. We thought that it is desirable for each individual laboratory to research its own age related normal reference ranges.
Antibodies, Monoclonal ; Child* ; Humans ; Lymphocyte Count ; Lymphocyte Subsets* ; Lymphocytes* ; Reference Values*

Wiskott-Aldrich syndrome is an X-linked combined immunodeficiency disorder characterized by severely decreased number of platelets which are small in size, eczema resembling atopic dermatitis and recurrent infection. The serum of the patient contains elevated concentrations of IgA and IgE, whereas the IgG level is usually normal and IgM level is decreased. The patients also shows skin test anergy and progressive T-lymphocytopenia. Bleedings and recurrent infections are the main causes of death and the patients usually die before age 10. Bone marrow transplantation is accepted to be the only radical therapy. We experienced a case compatible with Wiskott-Aldrich syndrome in a 5 year old male child who accompanied above clinical manifestations and laboratory findings.
Bone Marrow Transplantation ; Cause of Death ; Child ; Child, Preschool ; Dermatitis, Atopic ; Eczema ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Male ; Skin Tests ; Thrombocytopenia ; Wiskott-Aldrich Syndrome* ; X-Linked Combined Immunodeficiency Diseases

BACKGROUND: Vitiligo is considered as an autoimmune disorder due to the generation and presence of autoantibodies directed against melanocyte antigens in the patients sera. Previous studies have revealed an increased incidence of organ-specific autoantibodies in vitiligo patients. A number of studies have demonstrated an increased frequency of thyroid autoantibodies in vitiligo patients and vitiligo is commonly seen in patients with clinical thyroid diseases. OBJECTIVE: The aim of this study is to investigate the incidence of antithyroid antibodies in vitiligo patients and to correlate the presence of these antibodies with factors such as sex, age, activity of the disease, duration of the disease and the type of vitiligo. Another aim of this study is to compare the incidence of abnormal thyroid function in those who have antithyroid antibody and those who don't. METHODS: One hundred and fifty seven vitiligo patients who visited vitiligo clinic in Samsung medical center from January of 1995 to November of 1996 were enrolled in this study. Detection and titration of antithyroid antibodies were performed by immunoradiometric assay. RESULTS: Among 157 patients tested, 17(10.8%) patients had antithyroglobulin antibodies and 10(6.4%) patients had antimicrosomal antibodies. Five patients had both antibodies. Statistically meaningful data are as follows; 1) Antimicrosomal antibody appeared less frequently in patients of childhood-onset. 2) Antithyroglobulin antibody was detected more frequently in active disease. Fifty nine out of 157 patients were examined for thyroid function. Four out of 22 patients with antithyroid antibody had abnormal thyroid function. None out of 37 patients without antithyroid antibody had abnormal thyroid function. CONCLUSION: The incidence of antithyroid antibodies according to onset age and activity is contradictory to previous reports, therefore large scaled study will be necessary to draw a conclusion.
Age of Onset ; Antibodies* ; Autoantibodies ; Humans ; Immunoradiometric Assay ; Incidence* ; Melanocytes ; Thyroid Diseases ; Thyroid Gland ; Vitiligo*

No abstract available.

INTRODUCTION: The fixation strength of transpedicular screw system in the vertebral hody relied on bone quality and anatomical characteristics of vertebral pedicle, designs of screw and types of connection(rod or plate) with screw. The purpose of this study is to verify the biomechanical nature of the transpedicular fixation in spine under various conditions with porcine vertebrae. MATERIAL AND METHOD: Fresh porcine vertebrae and the custom-made screws were used in this experiment. To reduce the errors caused by vertebral bodies of different size and quality, vertebral bodies having regular range of pedicular width(10.0 to 11.5mm) and hone density(more than 1.0 gm/cm2) were used. The pedicle screws were inserted in the same procedure and axial pull out test was performed with using the Material Testing System(lntron8511, Canton, USA). The experiments were performed in four types to assess the difference of strength accroding to designs of the screw hy using two group of screws. The first group of screw was designed according to the outer and inner diameter and the second group was designed according to the shape, pitch, and thread profile of screw. Experiment I was perfomed to evaluate the effect of screw diameters on the biomechanical pull-out strength hy using the first group of custom-made pedicle screw which fixed all other factors except the diameter of screw. Experiment I was to verify the effect of screw shape, experiment III to verify the effect of pitch and experiment IV to verify the effect of thread profile. RESULTS: The results of experiments were summarized as follows: Experiment I showed that the screw of larger outer diameter had greater holding strength. Experiment II showed that the holding strength of cylindrical shaped screw is superior to that of conical shaped screw. Experiment III showed that there is no statistical significance between different modes of pitch. Experiment IV showed that the holding strength of buttress shape of thread profile is superior to that of V-shape. CONCLUSION: It seemed that the fixation strength of the screw was more powerful with 1 mm increment of outer diameter in 4-7mm of outer diameter, 3mm of pitch and buttress shape of thread of the screw with the same operation technique.
Spine