In lepromatous leprosy, it is generally believed that there is not only defective CMl specific for M. leprae, but also generalized impairment of CMI and in erythema nodosum leprosum, an immune complex-mediated pathogenesis as well cell mediated immune pathogenesis have been proposed. Neopterin is a pyrazinopyrirnidine compound derived from GTP, its raised excretion has been related to activation of T-lymphocyte/macrophage axis. A study was performed to evaluate generalized CMI status in the LL and ENL and to investigate a relationship between levels of urinary neopterin and disease activity. Urinary neopterin was measured by high pressure liquid chromatography in 25 healthy subjects, in 25 patients with LL and in 25 patients with ENL. The results were as follaws 1. Urinary Neopterin levels of patients with LL was 188.9+147.3umol/mol creatinine, which was higher than that of control group(144.8+40.4umol/mol creatinine)(p<0.01). 2. Urinary Neopterin levels of patients with ENL was 884.1+970.5umol/mol creatinine, which was higher than of control group, and patients with LL(p<0.01, p<0.01). 3. Serial measurement of urinary neopterin from 1 week to 13 weeks after treatment of ENL in 4 cases of ENL showed good correlation between urinary neopterin levels and disease activity. In summary, it thus appears that measurement of urine neopterin in leprosy provides generalized CMI status and reliable index for activity of disease.
Axis, Cervical Vertebra ; Chromatography, Liquid ; Creatinine ; Erythema Nodosum* ; Erythema* ; Guanosine Triphosphate ; Humans ; Leprosy ; Leprosy, Lepromatous* ; Neopterin*

Idiopathic midline destructive disease(IMDD) is a subgroup of midline granuloma syndrome, which is a clinical entity characterized by a relentless uilcer ation of the upper air way involving the nose, the palate, and the face, with a fatal outcorne. A 32 year-old male had symptoms of nasal obstruct.ion and rhinorrhea for about 4 months prior to visiting the hospital ad was referred to our Department for evaluation of a verely destruct.ive skin lesions on his face. The patient, revealed unique clinopatholcgic featurs compat with IMDD. These were : 1) prescence of locally destructive lesion which were restricted to the upper respiratory tract. 2) abscence of systemic disease durin the follow up peroid, 3) The histologic features consisted of acute and chronic inflarnmation with a variable dearel of necrosis on the examination of repeated biopsy specimens, 4) inabiliy to demonst rate an infectious causative organisms on repeated laboratory tests.
Adult ; Biopsy ; Follow-Up Studies ; Granuloma* ; Humans ; Male ; Necrosis ; Nose ; Palate ; Respiratory System ; Skin

No abstract available.
Female ; Laparoscopy* ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic*

BACKGROUND: External ventricular drainage (EVD) is an important procedure for draining excessive cerebrospinal fluid (CSF) and monitoring intracranial pressure. Generally, EVD is performed in the operating room (OR) under aseptic conditions. However, in emergency circumstances, the operation may be performed in the intensive care unit (ICU) to save neuro-critical time and to avoid the unnecessary transfer of patients. In this study, we retrospectively analyzed the risk of EVD-induced CNS infections and their outcomes according to the operating place (ICU versus OR). In addition, we compared mortalities as well as hospital and ICU days between the CNS infection and non-CNS infection groups. METHODS: We reviewed medical records, laboratory data and radiographic images of patients who had received EVD operations between January, 2013 and March, 2015. RESULTS: A total of 75 patients (45 men and 30 women, mean age: 58.7 +/- 15.6 years) were enrolled in this study. An average of 1.4 catheters were used for each patient and the mean period of the indwelling catheter was 7.5 +/- 5.0 days. Twenty-six patients were included in the ICU group, and EVD-induced CNS infection had occurred in 3 (11.5%) patients. For the OR group, forty-nine patients were included and EVD-induced CNS infection had occurred in 7 (14.3%) patients. The EVD-induced CNS infection of the ICU group did not increase above that of the OR group. The ICU days and mortality rate were higher in the CNS infection group compared to the non-CNS infection group. The period of the indwelling EVD catheter and the number of inserted EVD catheters were both higher in the CNS infection group. CONCLUSIONS: If the aseptic protocols and barrier precautions are strictly kept, EVD in the ICU does not have a higher risk of CNS infections compared to the OR. In addition, EVD in the ICU can decrease the hospital and ICU days by saving neuro-critical time and avoiding the unnecessary transfer of patients. Therefore, when neurosurgeons decide upon the operating place for EVD, they should consider the benefits of ICU operation and be cautious of EVD-induced CNS infection.
Catheter-Related Infections ; Catheters ; Catheters, Indwelling ; Cerebrospinal Fluid ; Drainage* ; Emergencies ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Operating Rooms* ; Retrospective Studies ; Ventriculostomy

Craniofacial clefts are rare among facial anomalies with an incidence of 1.5 to 5 per 100,000 births, and 1 per 100 cases of cleft lip and palate. The Tessier No. 7 clefts are unusual lesions that result from failure of the embryonic mandibular and maxillary processes to properly fuse and form the corners of the mouth. We experienced a case of Tessier No. 7 craniofacial cleft in a 1 day-old female patient who presented with a macrostomia and auricular malformation. The diagnosis was established by clinical and radiographic findings. A brief review of literature was made.
Cleft Lip ; Diagnosis ; Female ; Humans ; Incidence ; Macrostomia ; Mouth ; Palate ; Parturition

It is commonly believed that the branchial anomalies are persistent remnants of the embryologic branchial apparatus. These anomalies are originated from branchial cleft and most commonly involved in second branchial deft. Clinically they present palpable mass, discharge from fistula, recurrent infection due to obstruction of Gstula tract. As respiratory symptoms, they may present hoarseness, preceeded by or associated with upper respiratory infection. However, it has not been reported that they caused airway obstruction in newborn infants. Wc experienced a case of the fourth branchial deft cyst in a 2 day old infant who showed respiratory difficulty due to airway obstruction.
Airway Obstruction ; Branchial Region* ; Branchioma* ; Fistula ; Hoarseness ; Humans ; Infant ; Infant, Newborn

BACKGROUND: A clinical study of rosacea has never been reported in Korea. OBJECTIVE: The purpose of this study was to elucidate the clinical observations of rosncea. METHODS: During a 5-year-period from Jan. 1990 to Dec. 1994, 133 patients were evaluated with regard to age, sex, location of skin lesions, clinical type, duration, and precipitating factors. RESULTS AND CONCLUSIONS: 1. Of the 7,787 cases amongst outpatients, 133 cases(1.7% ) were dignosed with rosacea. Of there 46 were male patients and 87 females, giving a sex ratio of 1:1.9 in favor of females. 2. The most common type of rosacea was vascular rosacea(60.2%) 3. The average duration of rosacea was 3.4 years. 4. Rosacea afflict persons aged 40-49 most frequently. 5. The predilection sites of the rosacea were : cheek(42.9%), nose(23.3%), entire face(11.3%), cheek & nose(9%), zygomatic area(6.8%), extra-facial area(3.8%), forehead(2.9%). 6, The aggravating factors of rosacea were : unknown cause(32.3%), coffee & tea(18%), alcohol(13.5%), emotional stress(10.5%), sun exposure(9.8%), multi-factoral(7.5%), drugs(steroids)4.6%).
Cheek ; Coffee ; Female ; Humans ; Korea ; Male ; Outpatients ; Precipitating Factors ; Rosacea* ; Sex Ratio ; Skin ; Solar System

No abstract available.
Emphysema* ; Heart Septal Defects, Ventricular*

Borderline malignant ovarian tumor are characterized as neoplasrns exhibiting cellular priliferative changes greater than those seen in the benign form, but not showing destnictive invasion of the ovarian strama. We reviewed 14 cases of borderline ovarian tumor who had been diagnosed and treated at Kyung Pook university hospital from 1987 to 1992. We nnalysed the clinical features, treatment and prognosis which were compared to 24 cases of the epithelial ovarian cancer at the same period The most common histological thpe of boderline tumnr was mucinous type (1 l cases, 79%), the next one was serous type (3 cases, 21%). In FIGO stage of Borderline tumor, 11 caseS weve stage I a, 1 with stage II c, 1 with stage gb and 1 with stage lV, and the FIGO stage of 24 cases of ovarian cancer was 8 cases with stage I a, 1 with stage I b, 2 with stage I c, 1 with II c, 2 with stage III a, 1 with stage III b, 7 with stage III c and 2 with stage 1V. The mean age of borderline and malignant tumor was 37.1 and 47.6 years.. 3 cases were being pregnant on the operatian. In the 14 cases of borderline turnor, 7 cases were managed by conservative operation, but 1 case recurred 4 years later so extirpative operation and pastoperative chemotherapy were given. The other 4 cases were managed by extirpative operation but postoperative chemotherapy was given in only 1 patient. Follow up ranged from 7 to 72 months. 12 cases were alive. 2 cases died, one was stage III b, the other was atage IV. This atudy suggeat, that it is neceasary to follow up carefully even the early stage of botderline tumor and manage as oyarian carcinama in the advanced stage.
Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Mucins ; Ovarian Neoplasms ; Ovary* ; Prognosis

OBJECTIVE: The pathogenesis of endometriosis is generally accepted that retrograde menstruation and alterations in the local pelvic immune environment. This study was performed to help elucidate what kind of role various cytokines might play in the pathogenesis of endometriosis. METHOD: Concentrations of peritoneal fluid cytokines were compared in 7 women with normal pelvic finding and 23 women with endometriosis by enzyme-linked immunosorbent assay(ELISA). The patterns of cytokine mRNA expression in 8 ovarian endometrioma and 12 superficial pelvic endometriosis lesions were investigated by reverse transcription-polymerase chain reaction(RT-PCR) amplification method. RESULT: Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal. However, there were no significant differences between peritoneal fluid concentrations of IFN-gamma, TNF-alpha, IL-1beta, and IL-5 of women with and without endometriosis. The levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compared to women with mild endometriosis. IL-1beta mRNA was expressed in all of 8 deep and 12 superficial endometriosis lesions. IL-5 and IL-6 mRNA were expressed in only two black lesions respectively, however, both were not expressed in the all deep lesions. Expressions of IL-10 mRNA occurred in one red and one black lesion while this was expressed in only one of the deep lesions. TNF-alpha mRNA was expressed in one red and one black lesion of 12 superficial lesions compared with four of the deep lesions. There was the difference between kinds of increased cytokines in the peritoneal fluid and those of expressed cytokines in the endometriotic lesions of patients with endometriosis. CONCLUSION: This study supports the concept that local immunologic factors may be important in the pathogenesis and pathophysiology of endometriosis. The pattern of cytokine mRNA expression of endometriotic lesions would seem to indicate that proinflammatory cytokines such as IL-1beta and TNF-alpha are responsible for the development or progression of endometriosis.
Ascitic Fluid ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunologic Factors ; Interleukin-10 ; Interleukin-5 ; Interleukin-6 ; Menstruation Disturbances ; RNA, Messenger* ; Tumor Necrosis Factor-alpha