Responses of mouse lymphocytes to the soybean paste fermented by Korean traditional fashion was examined to clarify its effects in cytokine production in vitro. A fraction of the soybean paste (KFSP-100) was prepared by precipitation with ammonium sulfate and by filtration through ultrafiltration membrane. KFSP-100 were added into cultures of fresh mouse splenic cells in vitro. KFSP-100 significantly enhanced the amount of IL-6 and TNF-a produced by macrophages and IL-6 and IFN-r produced by lymphocytes. Production of IL-12 by macrophages was not much affected by KFSP-100 treatments. The most noticeable finding was the fact that lymphocytes treated with KFSP-100 proliferated to an exceeding numbers (more than 10 times to the control) in 72 hours. The KFSP-100-induced proliferative response was specific to B cells since almost all of the KFSP-100-induced cells in the cultures of splenic cells were B cells. Furthermore, such a proliferative responses were equally observed only in cultures of purified B cells but not in cultures of T cells. In thermostability test, the biologically active components of the KFSP-100 is assumed to be either linear protein or glycoprotein. KFSP-100 did not induce agglutination of lymphocytes demonstrated by lectins in the same cells. These observations suggest that KFSP-100 may be a novel mitogen for B lymphocytes. The component (s) responsible for the B cell proliferation in KFSP-100 might be a factor gained by natural fermentation. None of the fractions of not fermented soybean paste prepared by the same methods demonstrate the same effect.
Agglutination ; Ammonium Sulfate ; Animals ; B-Lymphocytes ; Cell Proliferation ; Fermentation ; Filtration ; Glycoproteins ; Immunologic Factors* ; Interleukin-12 ; Interleukin-6 ; Lectins ; Lymphocytes ; Macrophages ; Membranes ; Mice ; Soybeans* ; T-Lymphocytes ; Ultrafiltration

We have used BALB/c mice as an animal model for the study of anaphylactic hypersensitivity to the house dust mite. For the sensitization, BALB/c mice were injected with a single dose of extracts of Oermatophagoides farinae (D. pa) or Dermatophagoides pteronyssinus (D. pt) mixed with adjuvants (aluminum hydroxide and Bordetella pertussis) intraperitonealy. On days of 15, 30, and 60 after the sensitization, the mice received a challenge dose of the same allergen intravenously to induce anaphylactic shock. The hypersensitivity reactions were scored by anaphylactic shock. And various immunological parameters, including cytokines and immunoglobulin isotypes, were studied in relation with the shock. A high level of anaphylactic shock was produced in the mice by both of the allergens, D, fa and D, pt, at 15 and 30 days after sensitization. In vitro Ag specific proliferative reponses of spleen cells from D. pt treated mice (D. pt mice) was six times higher than those from O. fa treated mice (O. fa mice). Regardless the differences in antigens, the production of IFN-r by spleen cells from D. pt mice or O. fa mice was equally high at 15 days after sensitization. However, the ability to produce IFN-r by the spleen cells from D, pt mice was three times higher compared to that from D. fa mice. The production of IL-4 by the spleen cells was enhanced slightly but not significant in both groups. In studies of the allergen-specific immunoglobulin isotypes in the sera of the mice, the level of IgE in both groups was enhanced slightly but not significant. In contrast, the level of IgG subtypes were increased in both groups. When the levels of IgG were compared by subtypes, the level of IgG1 increased significantly on day 15 when the anaphylactic shock score was maximized in both groups. Increase in IgG2a level at the day was not significant, instead, asignificant increase in IgG2 levels was observed on day 60 after sensitization when the anaphylaxis was almost discontinued. Although a higher level of IgG3 was examined on day 15 and 30 in D. pt mice and on day 60 in D, fa mice, anaphylaxis was not appeared to be associated with the levels of IgG3 in this study. The IgG1, rather than IgE, was assumed to the major factor involved in the anaphylactic response observed in this experiment. In conclusion, BALB/c mice would be an animal model for the study of anaphylactic hypersensitivity to D. fa or D, pt., which might be an essential tool for the future development of immuno-therapeutic agents.
Mice ; Animals

Methemoglobinemia can be caused by dapsone toxicity. We report a case dapsone induced methemoglobinemia unresponsive to methylene blue successfully treated by exchange transfusion. A 52-year-old male ingested a handful of dapsone. He presented with severe peripheral cyanosis in lips and fingertips and his methemoglobin level was found to be 21.9%. After admission, methylene blue (1%) at 1 mg/kg was injected each time peripheral cyanosis and rising serum methemoglobin occurred. Despite methylene blue therapy, the patient's methemoglobin level continued to fluctuate. Five days after the injections of methylene blue, many Heinz bodies were visualized in the peripheral blood, suggestive of hemolytic anemia occurrence. By hospital day 6, serum methemoglobine levels were elevated and not measurable (> 50%) and the patient was constantly in a semi-comatose mental state. An exchange transfusion carried out by utilizing 6 units of packed red blood cells and 4 units of fresh frozen plasma was performed. The patient's methemoglobin levels were subsequently kept up below 20% and his peripheral cyanosis receded. Physicians should recognize the important role of exchange transfusion in refractory dapsoneinduced methemoglobinemia.
Anemia, Hemolytic ; Cyanosis ; Dapsone ; Erythrocytes ; Hand ; Heinz Bodies ; Humans ; Lip ; Male ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Middle Aged ; Plasma

Horse chestnut (Aesculus hippocastanum) is a common tree found on roads and parks. The shape of the fruit is very similar to that of the edible Korean chestnut (Castanea crenata); thus, people can eat it by mistake. However, reports of the side effects and toxicity from ingestion are very rare. A 46-year-old male who had no unusual findings in the past had eaten horse chestnut seed which he had mistaken to be Korean chestnut. He visited the emergency department (ED) with complaints of epigastric pain, nausea, and sweating. Blood tests showed a slight increase in the levels of liver enzymes, serum amylase, and pancreatic amylase. During the monitoring, he complained of palpitations, and electrocardiogram showed atrial fibrillation. On the following day after conservative treatment, blood testing and electrocardiogram showed normal findings. He was discharged from the ED as he did not complain of any further symptoms. When a patient who has eaten horse chestnut visits the ED, blood examination and electrocardiogram monitoring are needed, and conservative treatment is required.

No abstract available.
Hormone Replacement Therapy ; Humans ; Incheon* ; Osteoporosis* ; Physicians, Primary Care* ; Primary Health Care*

Some individuals may demonstrate a secondary phase nystagmus (SPN) following the caloric irrigation. It has been stated that if a SPN begins prior to 140 seconds after the onset of caloric stimulation and if the magnitude of the slow phase velocity is greater than 6 degrees/sec, then a premature reversal caloric nystagmus (PRCN) is said to exit. Thus far, there have been no reports describing PRCN in Korea. We described a typical PRCN in a patient with medulloblastoma within the 4th ventricle. The patient had a gaze-evoked horizontal and upbeating nystagmus. However, there was no indication of spontaneous nystagmus. A monothermal caloric test was administered. The initial left beating primary phase nystagmus was subsided at 60 seconds after right cold water stimulation and at 110 seconds, a right beating SPN with 14 degrees/sec of slow phase velocity was appeared and was continuous for 240 seconds. Although the precise mechanism of PRCN is unknown, vestibular nuclei damage may be related.
Caloric Tests ; Humans ; Korea ; Medulloblastoma ; Nystagmus, Physiologic* ; Vestibular Nuclei ; Water

BACKGROUND: For decades, patients with epilepsy and mental retardation (MR) have been considered as a relative contraindication for focal resective epilepsy surgery. However, considerable debate exists concerning whether the presence of MR is a contraindication for epilepsy surgery or not. We examined the postsurgical seizure outcome of temporal lobe epilepsy (TLE) according to preoperative intelligence scores and the relationship between preoperative intelligence and postsurgical seizure outcomes of TLE. METHODS: We investigated 131 patients with TLE divided into two groups according to standard IQ ranges and seizure outcomes were compared by Engel's classification. RESULTS: The percentage of seizure free patients after surgery was 66.4% in all patients and the percentage in patients with and without MR were 60.7% and 68%, respectively. The age at seizure onset was significantly different between the MR group and non the MR group. However, other factors which have been thought to affect the intelligence of patients with TLE were not significantly different between the two groups. The best postoperative seizure outcome was shown in the borderline group, where the frequency of hippocampal sclerosis and age at seizure onset were significantly higher compared to the other groups. CONCLUSIONS: Although preoperative MR has been regarded as a predictor for a poor prognosis of surgical outcome, our results suggest that MR alone is not a contraindication for epilepsy surgery. Therefore, epilepsy patients with MR who meet other inclusion criteria for epilepsy surgery should not be rejected for epilepsy surgery.
Classification ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Intellectual Disability* ; Intelligence ; Prognosis* ; Sclerosis ; Seizures ; Temporal Lobe*

OBJECTIVE: To investigate the effect of mirror therapy on recovery of upper limb function and strength in subacute hemiplegia after stroke. METHOD: Fourty subacute hemiplegic stroke patients (onset <6 months) were enrolled and randomly assigned to either the mirror therapy (MT, n=19), or control group (n=21). MT group received mirror therapy for 30 minutes after each treatment, additionally with the traditional rehabilitation programs, 5 days per week for 4 weeks; 2 hours or more per day, 3 days or more per week. To measure the outcome, we performed the manual muscle test (MMT), manual function test (MFT) and Jarmar grip strength test. RESULTS: MT group showed significant improvements in MMT, grasp and lateral pinch force of grip strength test (p<0.05), compared to control group. Improvement in MFT was more evident in MT group (p<0.05). CONCLUSION: Mirror therapy can be used as an adjuvant therapeutic technique for improving upper limb function and strength for subacute hemiplegia.
Hand Strength ; Hemiplegia ; Humans ; Muscle Strength ; Muscles ; Organometallic Compounds ; Stroke ; Upper Extremity

Propafenone is a Class Ic antidysrhythmic agent, used in the management of atrial fibrillation. This is also a calcium channel and a weak beta blocker. The conventional therapy of hypotension induced by propafenone overdose includes fluid resuscitation followed by inotropic support. NaHCO3 is considered to be the treatment of choice. We report a case of successful insulin therapy for propafenone-induced hypotension unresponsive to NaHCO3. A 41-year-old woman with a prior medical history of atrial fibrillation presented to the ED after ingesting 4500 mg of propafenone, prescribed for her atrial fibrillation treatment. On initial examination, she was alert with O2 saturation of 96% and normal vital sign. Fifteen minutes later, her electrocardiogram revealed polymorphic ventricular tachycardia and then changed to ventricular fibrillation. When CPR was stopped, her BP was 70/40 mmHg, HR was 68 beats/min with wide QRS complex. Normal saline and inotropics were administered rapidly to improve hypotension. And we injected NaHCO3. Her blood pH was kept between 7.45 and 7.55. But, BP was not improved. Refractory to the conventional therapy for sodium channel blocker toxicity, we decided to try insulin treatment, considering properties of propafenonen having beta and calcium channel blocking effect. We administered short-acting insulin. Her blood glucose level was kept euglycemia by continuous 5% dextrose infusions and tried to keep serum potassium normal range. Thirty minutes after adminstering insulin, her SBP was checked at 100 mmHg. She was discharged 8 days post-ingestion without further complications. Insulin must be considered in severe hypotension induced by propafenone overdose unresponsive to other conventional therapy.
Adult ; Atrial Fibrillation ; Blood Glucose ; Calcium Channels ; Cardiopulmonary Resuscitation ; Electrocardiography ; Female ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Insulin ; Insulin, Short-Acting ; Potassium ; Propafenone ; Reference Values ; Resuscitation ; Shock ; Sodium ; Sodium Bicarbonate ; Sodium Channels ; Tachycardia, Ventricular ; Ventricular Fibrillation ; Vital Signs

The authors report two cases of clozapine-induced acute hepatitis. Two patients developed asymptomatic hepatitis and got better with conservative care. We decreased the dosage of clozapine and added hepatic protectors, resulting in normalized laboratory findings. The authors also reviewed side effects of clozapine in this report. We reviewed the suggested mechanism of either clozapine or chlorpromazine-induced hepatitis. Clozapine influences the liver cell via cytochrome P 450 and chlorpromazine does so via mild cholestasis. There may be a possibility that a patient who has experienced drug-induced hepatitis is vulnerable to clozapine-induced acute hepatitis. In this respect, those who have experienced drug-induced hepatitis must be observed more closely.
Chlorpromazine ; Cholestasis ; Clozapine ; Cytochrome P-450 Enzyme System ; Drug-Induced Liver Injury ; Hepatitis* ; Humans ; Liver