BACKGROUND: Sepsis is a clinical syndrome characterized by a systemic inflammatory and hemodynamic response to severe bacterial infections that involve various mediators. Endothelin (ET)-1, a potent vasocon strictor is associated with multiple organ failure, and interleukin (IL)-8, a proinflammtory cytokine, plays a major role in neurophil activation. Both have been reported to be useful parameters in the clinical assessment of sepsis. The levels of ET-1 and IL-8 in the blood were measured in patients with sepsis, and the correlation of both parameters and their relationship with the clinical data was assessed. METHODS: 19 sepsis patients and 17 controls were studied. Blood samples of the sepsis patients were drawn in day 1, 3, 7, and 14. the APACHE III scores were calculated in concurrent days. The ET-1 and IL-8 levels were measured using immunoassay methods. RESULTS: The ET-1 levels of patients with sepsis were significantly higher than in the controls. In patients with sepsis, non-survivors had higher ET-1 levels than survivors on day 1 and 7, and patients with shock also had higher ET-1 levels than normotensive patients on admission. The ET-1 levels were significantly correlated wit the creatinine levels in day 1, 7, and 14. The IL-8 levels showed a significant correlation with the ET-1 levels on day 14. CONCLUSION: ET-1 was found to be closely related with the clinical outcome, shock, and renal failure, and showed a correlation with IL-8. these mediators can be considered not only to play pathophysiologic roles but also as useful parameters in the clinical assessment of sepsis.
APACHE ; Bacterial Infections ; Creatinine ; Endothelin-1* ; Endothelins ; Hemodynamics ; Humans ; Immunoassay ; Interleukin-8* ; Interleukins ; Multiple Organ Failure ; Naphazoline ; Renal Insufficiency ; Sepsis* ; Shock ; Survivors

Adherence of Candida albicans(C. albicans) to the surface of a denture is believed to be an initial and essential step in the formation of denture-induced stomatitis. Previous studies have provided enormous infomation on the relationship between composition of palatine gland/parotid saliva and upper denture stomatitis. Relatively little information is available on the correlation between lower denture stomatitis and sublingual-submandibular(SLSM) saliva. The plaque samples were collected from the two sites(100mm2) on the inner surface of lower partial denture corresponding to the stomatitis and healthy region of the lower partial dentures of 12 denture stomatitis patients and 6 normal persons who wore lower partial dentures. The samples were plated to isolate C. albicans on a selective Saboraud's dextrose agar plate and the isolates were identified by germ tube test and gram staining. The subjects were divided into group I (stomatitis with C. albican), group II (lesion without C. albicans), group III (no lesion but C. albicans), and group IV (normal and healthy denture wearer). Individual SLSM saliva (20microgram of protein) was analyzed by SDS-PAGE(SDS-poly-acrylamide gel electrophoresis) with Coomassie brilliant blue and PAS(Periodic Acid Schiff) staining. The salivary proteins separated in the polyacryamide gels were subjected to immunoblot analysis using anti-lactoferrin, anti-sIgA, and anti-secretory component of sIgA. In this study using custom made acrylic denture resin beads(5mm in diameter) coated with stimulated individual SLSM saliva, the binding ability of individual C. albicans strains to the beads was observed. Levels of C. albicans adhered to the acrylic resin beads were determined by measuring the optical density of the bound C. albicans to the beads at 580nm. The results showed that a higher number of C. albicans was observed in the lesion site than health site. The saliva of group I contained more high molecular weight glycoprotein(mucin, MG1) as compared to group II, III, and IV. And lactoferrin and sIgA affected to the binding ability of C. albicans to acylic resin beads. Binding ability of individual C. albicans to the acrylic resin coated with respective individual saliva was found to be greater in group I than the other 3 groups. And when bound cells of C. albicans isolated from individual subject #2 to the saliva coated beads were used, binding ability of subject #2 saliva coated beads was founed to be greater than the other subjects. These results suggested that denture induced stomatitis is related to individual patient's salivary protein composition, especially MG-1. Future studies will be directed toward saliva examination of patients who have general disease and analysis of pellicles formed on prosthesis with respect to oral disease.
Agar ; Candida albicans* ; Candida* ; Denture, Partial ; Dentures* ; Gels ; Glucose ; Glycoproteins* ; Humans ; Immunoglobulin A, Secretory ; Lactoferrin ; Molecular Weight ; Prostheses and Implants ; Saliva ; Salivary Proteins and Peptides ; Stomatitis ; Stomatitis, Denture*

As a material of metal-ceramic prosthesis, nickel as a form of Ni-Cr alloy has been used for many dental prostheses in many cases. However, several problems in use of the alloy have been revealed (ex ; tissue stimulation, skin allergy, hypersensitivity, cytotoxicity and carcinogenecity). Little is known about nickel with respect to the relationship between Ni-prosthesis and gaining of Ni-resistance in oral microorganisms. The present study was undertaken to check wheather use of Ni-prosthesis leads to occurrence of Ni-resistant microorganisms. So this study may suggest the possible relationships between the oral microorganisms and nickel-resistance in oral enviroment. Bacteria were isolated from the gingival crevicular fluid on the patients wearing Ni-Cr prosthesis. The isolated bacteria were tested for their Ni-resistance in nickel containing media at different concentration from 3mM to 110mM. E. coli HB101 was used as control. The Ni-resistant bacteria were isolated and biochemically identified. The Ni-resistant bacteria were tested several biochemical, molecular-biological tests. Performed tests were ; measuring the growth curve, antibiotic test, growth ability test in liquid media, isolation of the chromosome and plasmid, digestion of DNA by restriction enzyme, electrophoresis of chromosome and plasmid DNA, identification of Ni-resistant genes by the DNA hybridization. The results were as follows: 1) The bacteria isolated from gingival crevicular fluid on the patients wearing Ni-Cr alloy prosthesis showed nickel-resistance. 2) The isolated microorganisms grew at nickel containing media of high concentrations (60mM-110mM). 3) Based on the biochemical tests, the isolated microorganisms were identified as Enterococcus faecalis(13 cases), Klebsiella pneumoniae(1 case) and Enterobacter gergoviae(1 case). 4) Enterococcus faecalis expressed not only nickel resistance but also the multi-drug resistanceto several antibiotics ; chloramphenicol, kanamicin, streptomycin, lincomycin, clindamycin. However all strain showed the sensitivity against the tetracycline. 5) DNA hybridization result suggest that there is no homology between the previousely known gene of nickel resistance in Klebsiella pneumoniae and chromosomal DNA Enterococcus faecalis.
Alloys* ; Anti-Bacterial Agents ; Bacteria* ; Chloramphenicol ; Clindamycin ; Dental Prosthesis ; Digestion ; DNA ; Electrophoresis ; Enterobacter ; Enterococcus ; Enterococcus faecalis ; Gingival Crevicular Fluid* ; Humans ; Hypersensitivity ; Klebsiella ; Klebsiella pneumoniae ; Lincomycin ; Nickel ; Plasmids ; Prostheses and Implants* ; Skin ; Streptomycin ; Tetracycline

Erythema nodosum leprsum(ENL) is a painful, erythematous subcutaneous and dermal nodules which occurs mainly in lepromatous leprosy. Usually, it starts about 1 year after onset of treatment and lasts from a few days to weeks or months. Rarely it lasts for years. Although the lesions of ENL develop any part of the body, the favorite sites are extensor sites of the extremities, medial thigh, and face. We report a case of ENL which showed about 20 times recurrences for 3 years from 15months after initial treatment because of its widespread inflammatory lesions and duration of the disease. The ENL lesions recurred repeatedly with 2 weeks to 3months interval for 3 years and the tender reddish nodules developed not only in extremities but also on the trunk. During treatment course, he developed diabetes mellitus, Cushings syndrome as complications of long term use of corticosteroid and also developed xanthoma, hyperpigmentation, and ichthyosis.
Diabetes Mellitus ; Erythema Nodosum* ; Erythema* ; Extremities ; Hyperpigmentation ; Ichthyosis ; Leprosy, Lepromatous ; Recurrence ; Thigh ; Xanthomatosis

Spontaneous bacterial empyema (SBEM), a relatively rare complication of liver cirrhosis, is characterized by a bacterial infection of the transudative pleural fluid without obvious infection focus within the thoracic cavity. The analysis of pleural fluid shows characteristic 'infected transudate' with occasional identification of causative organism as in spontaneous bacterial peritonitis. The outcome is relatively favorable with early identification of the disease and subsequent proper an-tibiotic therapy alone. Closed horacotomy is not nece- ssary in most cases and may be even more hazardous. We report a case of SBEM in a 37-year old male patient with hepatitis B-virus associated liver cirrhosis, who recovered with antibiotic therapy alone.
Adult ; Bacterial Infections ; Empyema* ; Hepatitis ; Humans ; Liver Cirrhosis* ; Liver* ; Male ; Peritonitis ; Pleural Effusion ; Thoracic Cavity

No abstract available.
Apolipoproteins* ; Genotype* ; Humans ; Myocardial Infarction*

BACKGROUND: Angiogenesis is an essential process for the growth and metastatic ability of solid tumors. One of the key factors known to be capable of stimulating tumor angiogenesis is the vascular endothelial growth factor (VEGF). The serum VEGF concentration has been shown to be a the malignant pleural effusion showing a correlation with the biochemical parameters. The VEGF has been shown to play a role in the inflammatory diseases, but rarely in the tuberculosis (TB). The serum and pleural fluid VEGF levels were measured in patients with lung cancer and TB. Their relationship with the clinical and laboratory parameters and repeated measurement 3 months after various anticancer treatments were evaluated to assess the utility of the VEGF as a tumor marker. METHODS: Using a sandwich enzyme-linked immunosorbent assay, the VEGF concentration was measured in both sera and pleural effusions collected from a total of 85 patients with lung cancer, 13 patients with TB and 20 healthy individuals. RESULTS: The serum VEGF levels in patients with lung cancer (619.9±722.8ph/ml) were significantly higher than those of healthy controls (215.9±191.1pg/ml), However, there was no significant difference between the VEGF levels in the lung cancer and TB patients. The serum VEGF levels were higher in large cell and undifferentiated carcinoma than in squamous cell carcinoma and adenocarcinoma. The serum VEGF levels of lung cancer patients revealed no significant relationship with the various clinical parameters. The VEGF concentrations in the malignant effusion (2,228.1±2,103.0pg/ml) were significantly higher than those in the TB effusion (897.6±978.8pg/ml). In the malignant pleural effusion, the VEGF levels revealed significant correlation with the number of red blood cells (r=0.75), the lactate dehydrogenase (LDH)(r=0.70), and glucose concentration (r=-0.55) in the pleural fluid. CONCLUSION: The serum VEGF levels were higher in the lung cancer patients. The VEGF levels were more elevated in the malignant pleural effusion than in the tuberculous effusion. In addition, the VEGF levels in the pleural fluid were several times higher than the matched serum values suggesting a local activation and possible etiologic role of VEGF in the formation of malignant effusions. The pleural VEGF levels showed a significant correlation with the numbers of red blood cells, LDH and glucose concentrations in the pleural fluid, which may represent the tumor burden.
Adenocarcinoma ; Carcinoma ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Erythrocytes ; Glucose ; Humans ; L-Lactate Dehydrogenase ; Lung Neoplasms* ; Lung* ; Pleural Effusion ; Pleural Effusion, Malignant ; Tuberculosis ; Tuberculosis, Pleural* ; Tumor Burden ; Vascular Endothelial Growth Factor A*

We report a man who presented with progressive disinhibition and through clinicoradiologic correlation using magnetic resonance imaging (MRI), aim to investigate the pathomechanism of disinhibition in neuro-Behcet's disease (NBD). A 46-year-old man presented with progressive disinhibition and apathy for 4 months. One month after his visit, additionally, he developed left partial third nerve palsy. His brain MRI showed lesions in the ventral caudate nucleus as well as left midbrain and thalamus. Taking his recurrent oral ulcers, uveitis, and erythema nodosum into consideration, he was diagnosed with NBD. We found that progressive disinhibition could be one of presenting symptoms in BD and might be associated with the caudate nucleus. This finding suggests that involvement of the basal ganglia in BD prior to the involvement of the brainstem could result in unique clinical features such as behavioral changes without extrapyramidal signs.
Apathy ; Basal Ganglia ; Brain ; Brain Stem ; Caudate Nucleus ; Erythema Nodosum ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Oculomotor Nerve Diseases ; Oral Ulcer ; Thalamus ; Uveitis

We report a man who presented with progressive disinhibition and through clinicoradiologic correlation using magnetic resonance imaging (MRI), aim to investigate the pathomechanism of disinhibition in neuro-Behcet's disease (NBD). A 46-year-old man presented with progressive disinhibition and apathy for 4 months. One month after his visit, additionally, he developed left partial third nerve palsy. His brain MRI showed lesions in the ventral caudate nucleus as well as left midbrain and thalamus. Taking his recurrent oral ulcers, uveitis, and erythema nodosum into consideration, he was diagnosed with NBD. We found that progressive disinhibition could be one of presenting symptoms in BD and might be associated with the caudate nucleus. This finding suggests that involvement of the basal ganglia in BD prior to the involvement of the brainstem could result in unique clinical features such as behavioral changes without extrapyramidal signs.
Apathy ; Basal Ganglia ; Brain ; Brain Stem ; Caudate Nucleus ; Erythema Nodosum ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Oculomotor Nerve Diseases ; Oral Ulcer ; Thalamus ; Uveitis

We expressed anti-HBsAg human antibody fragment (B7 Fd) using pRSET-A vector and BL21(DE3)pLysS strain of E. coli. B7 Fd is composed only of variable domain (VH) and CH1 constant domain of IgG heavy chain molecule. This Fd molecule was solubilized using guanidine salt and then expressed in the form of inclusion body and successfully refolded into functional antibody molecule by rapid dilution in refolding buffer. B7 Fd reacted with d epitope of hepatitis B virus surface antigen (HBsAg). Its affinity was determined by competition enzyme-linked immunosorbent assay (competition ELISA). The K value of B7 Fd was 3.3 * 10.
Antigens, Surface ; Enzyme-Linked Immunosorbent Assay ; Guanidine ; Hepatitis B virus ; Humans* ; Immunoglobulin G ; Inclusion Bodies