CTLA-4 (=CD152), a T cell activation antigen, has been known to be homologous to CD28 in its molecular and genomic structure. Both of these two molecules are sharing their counterreceptors, B7 (CDSO) and B7-2 (CD86) and are known to play a crucial role in T cell activation. In previous our study it was reported that there are 2 forms of CTLA-4 antigen in activated human T cells, 30 kD membrane-bound form and 34 kD cytosolic-sequestered form and the former was less than 5 % of total of this antigen induced. Aims of this study are to confirm previous finding by using flow cytometry and to characterize the cytoplasmic form of human CTLA-4 by using ultrafiltration and immunoprecipitation techniques. In PHA stimulated peripheral blood lymphocyte surface expression of CTLA-4 was less than 2.1% of any of CD4+, CD8+ and CD56+ subsets. And the 34 kD form of CTLA-4 was detected in CDS+ subset only. This discrepancy confirms that 34 kD antigen is the cytoplasmic form of human CTLA-4. In ultrafiltration and subsequent Western blot analysis study this 34 kD antigen was detected in >100 kD fraction only. And in non-reducing condition this antigen formed high molecular weght complex (MW > 350 kD). In immunoprecipitation study using anti-peptide A antibody it was found that this high molecular weight complex consists of the 34 kD cytoplasmic form of CTLA-4 and previously unknown 54 kD antigen and 46 kD antigen at 1:1:8-10 ratio. And none of these 3 molecules were identified in membrane fraction of activated human T cell. The result of this study implies that CTLA-4 molecule induced upon T cell activation mainly sequestered in cytoplasrn and another signal is necessary to target this antigen on the activated T cell surface.
Antigens, CD27 ; Blotting, Western ; CTLA-4 Antigen ; Cytoplasm* ; Flow Cytometry ; Humans* ; Immunoprecipitation ; Lymphocytes ; Membranes ; Molecular Weight ; T-Lymphocytes ; Ultrafiltration

PURPOSE: To analyze the variable MRI features and clinical significance of intracranial cavernous realformation. MATERIALS AND METHODS: Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso- or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6months). RESULTS: Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type 11, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. CONCLUSION: Cavernous realformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to predict natural course and possibility of rebleeding of the lesion.
Classification ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Thrombosis

The principle of the tension band technique is to counteract the tensile forces acting across the fracture site and to convert them into compressive forces. We have experienced 37 fractures treated with tension band technique from 1975 to 1978 and the results are as followings; 1. 37 Cases of fracture were treated by tension band technique. Eight cases out of 37 were olecranon fractures. 16 cases were patellar fractures. 10 cases were malleclar fractures. and three cases were trochanteric fractures of the femur. 2. As post-operative immobilization, applied cast splint in almost of the cases except application of hip spica cast in trochanteric fracture. 3. The average duration of immobilization in each cases, 12 days in olecranon, two weeks in patella, four weeks in malleolus and six weeks in greater trochanter respectively. 4. The radiological union was obtained in seven weeks in olecranon, six weeks in patella, eight weeks in malleolus and six weeks in greater trochanter. 5. As complication, one case of nonunion in olecranon, one case of infection and, one case of wire breakage in patella and one case of traumatic arthritis in malleolus were noted, which needed further surgery. 6. In conclusion, tension band wiring is considered as a good method for the fractures involving joing, olecranon, patella, and malleolus because the technique has advantages such as rigid internal fixation, shortening the duration of immobilization and fracture healing and early mobilization of the neighboring joints.
Arthritis ; Early Ambulation ; Femur ; Fracture Healing ; Hip ; Hip Fractures ; Immobilization ; Joints ; Methods ; Olecranon Process ; Patella ; Splints

Between August 1994 and June 1995, seventeen patients diagnosed as having partial or complete ruptures of the anterior cruciate ligament on MRI were managed by non-operative methods. Among them four patients were excluded due to operation during follow-up and the results were evaluated at a one year follow-up. We selected the patients prospectively for non-operative care using the selection criteria of age, degree of instability, activity level and patient compliance. The average age of them was 37.7 years. Initially knee stress test and MRI were checked, and Cybex study and Lysholm knee scoring were done at post-trauma one year follow-up. They were managed conservatively by ROM and muscle strengthening exercises and a brace fitting schedule for three months. Among them, six cases had partial tears and seven had a complete tear initially. At the one year follow-up, five of six cases who had shown partial ruptures, and two of seven cases with complete tears, recovered continuity of the ruptured ACL on MRI. Their Lysholm knee score was 84.4, and the Cybex test showed no difference in muscle power between the injured and uninjuried side. Those patients who had loss of continuity on follow-up MRI showed Lysholm score of 57.4 and decreased muscle power on Cybex study. Although there are still controversies about the adequate management of ACL injuries, our study suggests that conservative management is a viable alternative to surgery as long as the patients are selected prudently. For more concrete results, however, careful analysis based on a longer follow up period is necessary.
Anterior Cruciate Ligament* ; Appointments and Schedules ; Braces ; Exercise ; Exercise Test ; Follow-Up Studies ; Humans ; Knee ; Magnetic Resonance Imaging ; Patient Compliance ; Patient Selection ; Prospective Studies ; Rupture*

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

The nevus of Ota is a distinctive, mesodermal pigmentation of the facial skin commonly combined with pigmentation of the eye, usually congenital but capable of benign progression. It is usually unilateral, but in the 1st of these 2 cases, pigmentation of the facial skin and the eye was bilateral and associated with pigmentation of the left shoulder and the anterior cervical area(nevus of Ita). In the 2nd of these 2 cases, pigmentation of the eye and the shoulder was bilateral. Pigmentation of the eye accompanies that of sclera in every case, that of conjunctiva, iris and choroid in some case. It accompanies that of optic disc rarely, but in the 1st of these 2 cases, the pigmentation of optic disc was found in both eyes, in the 2nd, in the right eye. We have experienced the above-mentioned 2 cases of nevus of Ota associated with nevus of Ito which accompanied the pigmentation of optic disc, that are rare. We briefly reviewed the literature relating to nevus of Ota and Ito.
Choroid ; Conjunctiva ; Iris ; Mesoderm ; Nevus of Ota* ; Nevus* ; Pigmentation ; Sclera ; Shoulder ; Skin

No abstract available.
Animals ; Gram-Negative Bacteria* ; Interleukin-2* ; Mice*

A one step reverse transcription PCR (RT-PCR) combined nested PCR was set up to increase efficiency in the diagnosis of canine distemper virus (CDV) infection after developement of nested PCR. Two PCR primer sets were designed based on the sequence of nucleocapsid gene of CDV Onderstepoort strain. One-step RT-PCR with the outer primer pair was revealed to detect 10(2) PFU/ml. The sensitivity was increased hundredfold using the one-step RT-PCR combined with the nested PCR. Specificity of the PCR was also confirmed using other related canine virus and peripheral blood mononuclear cells (PBMC) and body secretes of healthy dogs. Of the 51 blood samples from dogs clinically suspected of CD, 45 samples were revealed as positive by one-step RT-PCR combined with nested PCR. However, only 15 samples were identified as positive with a single one step RT-PCR. Therefore approximately 60% increase in the efficiency of the diagnosis was observed by the combined method. These results suggested that one step RT-PCR combined with nested PCR could be a sensitive, specific, and practical method for diagnosis of CDV infection.
Animals ; Distemper Virus, Canine/genetics/*isolation & purification ; Dogs ; Polymerase Chain Reaction/*methods/*veterinary ; RNA, Viral/genetics/isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction ; Vaccines, Attenuated ; Viral Vaccines

No abstract available.
Humans ; Liver Neoplasms* ; Liver* ; Tissue Donors*

No abstract available.
Erythrocytes*