PURPOSE: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis. METHODS: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor(R)) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed. RESULTS: After partial orbital exenteration, the wound finally healed well without any additional abscess formation. CONCLUSIONS: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.
Prosthesis-Related Infections/diagnosis/*etiology/surgery ; Porosity ; Orbital Implants/*adverse effects ; Orbital Diseases/diagnosis/*etiology/surgery ; Magnetic Resonance Imaging ; Humans ; Follow-Up Studies ; Female ; Eye Enucleation ; Device Removal ; Aged ; Abscess/diagnosis/*etiology/surgery

BACKGROUND: Interleukin (IL)-4 is a pleiotropic cytokine that plays an important role in the pathogenesis of the allergic inflammation and asthma. Upon IL-4 receptor (IL-4R) engagement, a variety of signaling mediators, such as JAK kinases and STAT-6 are activated, leading to induction of IL-4 target gene expression including CD23 and germline C epsilon transcription. The function of a membrane-proximal domain of IL-4Ra, termed ID-1, remains to be characterized to date. OBJECTIVE: To assess whether the ID-1 domain mediates the induction of IL-4 target gene expression in a STAT-6-dependent manner. METHODS: The intracellular region of IL-4Ralpha was translationally fused to the extracellular region of IL-2Rbeta to provide ligand specificity to IL-2. Acidic amino acids and serine residues in the ID-1 domain of the chimeric receptor were substituted by site-directed mutagenesis. These receptor cDNAs were stably transfected to M12.4.1 murine B lymphoma cells. Following IL-2 stimulation, wild type and mutant clones for the ID-1 motif were subjected to FACS. RNA blotting and elecroporetic mobility shift assays to address the levels of CD23, germline C epsilon and STAT-6 inductions, respectively. RESULTS: ID-1 mutant clones were defective in gene induction of CD23 and germline C epsilon in response to IL-2 stimulation, as compared with wildtype clones. Moreover, IL-2-mediated STAT-6 activation was abolished in ID-1 mutant clones. CONCLUSION: These results demonstrate that the ID-1 domain of IL-4Ra is essential to induce IL-4 target gene expression through a STAT-6-dependent pathway.
Amino Acids, Acidic ; Asthma ; Clone Cells ; DNA, Complementary ; Electrophoretic Mobility Shift Assay ; Gene Expression ; Inflammation ; Interleukin-2 ; Interleukin-4 Receptor alpha Subunit* ; Interleukin-4* ; Interleukins ; Janus Kinases ; Lymphoma ; Mutagenesis, Site-Directed ; Receptors, Interleukin-4 ; RNA ; Sensitivity and Specificity ; Serine

PURPOSE: Muscular artery differs from elastic artery in physical properties and constituents of the arterial wall. To investigate the difference between muscular and elastic arteries, we measured the pulse wave velocities (PWVs) in lower extremity muscular arteries (femoral ankle PWV, faPWV) and abdominal elastic arteries (brachial femoral PWV, bfPWV), and searched for the relationships between the PWVs of muscular, elastic arteries and the risk factors of arteriosclerosis. METHODS: 184 normal volunteers were enrolled in the study. Among them, the ratios of male/female, smoker/non-smoker, and hypertension/normal were 81/103, 66/118, and 63/121, respectively. Using volume plethysmography, faPWV and bfPWV were measured. The risk factors of arteriosclerosis in this study were age, gender, smoking, hypertension, body mass index, low density lipoprotein, high density lipoprotein, triglyceride, hemoglobin A1C, and white blood cell. RESULTS: The PWVs of lower extremity muscular arteries (faPWVs) were significantly faster than those of abdominal elastic arteries (bfPWVs) (right, P<0.001; left, P<0.001) Multiple regression analysis revealed that the independent risk factors of the PWV were age (right, P<0.001; left, P<0.001) and gender (right, P=0.008; left, p=0.014) in abdominal elastic arteries. However, in lower extremity muscular arteries, hypertension (right, P<0.001; left, P<0.001) as well as age (right, P<0.001; left, P<0.001) and gender (right, P=0.009; left, P=0.001) were other significant independent risk factors. CONCLUSION: The PWVs of lower extremity muscular arteries were significantly faster than those of abdominal elastic arteries. The significance of hypertension in faPWV suggests that hypertension is an important risk factor in inducing arterial stiffness, especially in lower extremity muscular arteries.
Animals ; Ankle ; Arteries ; Arteriosclerosis ; Body Mass Index ; Extremities ; Hemoglobins ; Humans ; Hypertension ; Lipoproteins ; Lower Extremity ; Plethysmography ; Pulse Wave Analysis ; Risk Factors ; Smoke ; Smoking ; Vascular Stiffness

OBJECTIVE: We examined the association between the tryptophan hydroxylase 1 (TPH1) gene and eating disorders focusing on obsessionality. METHODS: The sample included 62 women with a lifetime diagnosis of anorexia nervosa (AN) as well as 50 women with a lifetime diagnosis of bulimia nervosa (BN) recruited from specialist clinics for eating disorders and 131 healthy women in Korea. Blood samples were collected from all participants for the TPH1 genotyping. The patients were ad ministered the Korean version of the Eating Disorders Examination and obsessionality was conceptualized using measures of persistence, harm avoidance, and obsessive-compulsive symptoms. RESULTS: In the case-control comparisons, the frequency of the A/A genotype was increased in the patients with BN, but this difference was not significant after correcting for multiple testing. We found no effect of the TPH A218C polymorphism on obsessionality in the patients with AN or BN. CONCLUSION: Although the present findings should be regarded as preliminary because of the small size of our sample, they suggest that the TPH1 gene may contribute to the genetic susceptibility to BN and be associated with the other unexplored traits of bulimic case status.
Anorexia Nervosa ; Bulimia Nervosa ; Case-Control Studies ; Eating ; Feeding and Eating Disorders ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Korea ; Obsessive Behavior ; Pilot Projects ; Specialization ; Tryptophan ; Tryptophan Hydroxylase

BACKGROUND: Frailty is considered to be a clinical syndrome characterized by decreased physiological reserves associated with a greater risk of health-related problems, hospitalization, and death. The current study examined hospitalization, falls, cognitive decline and disability between robust, prefrail and frail elderly in one year. METHODS: 110 participants aged 65 or more who visited two senior welfare centers in Seoul from February 2008 to June 2008 were surveyed again from March 2009 to June 2009 with demographic characteristics, number of chronic diseases and medication, study of osteoporotic fractures (SOF) frailty index, instrumental activity of daily living (IADL), depression, mini-mental state examination-Korean version (MMSE-K), falling history and admission history within one year. These results were compared with participants' previous survey done one year ago. RESULTS: Among total 110 subjects, 48 (44%) robust, 30 (27%) prefrail, and 32 (29%) frail subjects changed to 26 (24%), 54 (49%), and 30 (27%) respectively over the year. There were statistical significances in age, number of chronic disease, depressive mood, MMSE, falls, hospitalization, IADL disability contributing to frailty (P < 0.05). Frailty defined by SOF frailty index was associated with greater risk of adverse outcomes. Frail subjects had a higher age-adjusted risk of cognitive function decline (odds ratio [OR], 3.57), disability (OR, 9.64), fall (OR, 5.42), and hospitalization (OR, 4.45; P < 0.005). CONCLUSION: The frailty index like SOF frailty index might predict risk of falls, disability, hospitalization, and cognitive decline in the elderly, emphasizing special attention to the individuals showing frailty in outpatient examination.
Aged ; Chronic Disease ; Depression ; Frail Elderly ; Hospitalization ; Humans ; Osteoporotic Fractures ; Outpatients ; Retrospective Studies

OBJECTIVE: Mitochondrial dysfunction is a prominent and early feature of Alzheimer's disease (AD). The morphologic changes observed in the AD brain could be caused by a failure of mitochondrial fusion mechanisms. The aim of this study was to investigate whether genetic polymorphisms of two genes involved in mitochondrial fusion mechanisms, optic atrophy 1 (OPA1) and mitofusin 2 (MFN2), were associated with AD in the Korean population by analyzing genotypes and allele frequencies. METHODS: One coding single nucleotide polymorphism (SNP) in the MFN2, rs1042837, and two coding SNPs in the OPA1, rs7624750 and rs9851685, were compared between 165 patients with AD (83 men and 82 women, mean age 72.3±4.41) and 186 healthy control subjects (82 men and 104 women, mean age 76.5±5.98). RESULTS: Among these three SNPs, rs1042837 showed statistically significant differences in allele frequency, and genotype frequency in the co-dominant 1 model and in the dominant model. CONCLUSION: These results suggest that the rs1042837 polymorphism in MFN2 may be involved in the pathogenesis of AD.
Alzheimer Disease* ; Brain ; Clinical Coding ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Mitochondrial Dynamics ; Optic Atrophy, Autosomal Dominant ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

BACKGROUND: The development of metastasis in cancer is one of the main problems after primary tumor resection. The identification of metastases is only possible in the follow-up investigation when there is already a solid tumor mass. Subclinical tumor cell dissemination can be detected by immunocytological staining of cells or by other molecular biological methods, like PCR. We investigated 22 peripheral blood isolates from gastric cancer patients with a cytokeratin (CK) 20 specific nested reverse transcriptase PCR (RT-PCR) for the detection of disseminated tumor cells at the time of diagnosis. METHODS: Fresh heparinized peripheral bloods (about 10 mL) were obtained from 22 gastric cancer patients and 10 healthy doctors as controls. Nucleated cells were isolated by a density gradient method. RNA was isolated and then subjected to RT-PCR with CK 20 specific primers. RESULTS: In gastric cancer, 3 of 22 (13.6%) peripheral blood isolates yielded a CK 20 mRNA positive result in a stage undependent manner. CONCLUSION: We detected disseminated tumor cells in the peripheral blood isolated using CK 20 specific nested RT-PCR method. Studies on a larger scale are needed for further investigation on the relationship between positive rates of CK 20 mRNA and survival rates of stomach cancer, according to cancer stages.
Diagnosis ; Follow-Up Studies ; Heparin ; Humans ; Keratin-20* ; Keratins* ; Neoplasm Metastasis ; Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction* ; RNA ; RNA, Messenger ; RNA-Directed DNA Polymerase* ; Stomach Neoplasms* ; Survival Rate