BACKGROUND: Th2-like cells are thought to play a crucial role in the recruitment and activation of eosinophil in bronchial asthma. In contrast to Th2 cytokine, Thl cytokine IFN-y decreases eosinophil recruitment. Previous studies have shown that IL-12 promotes differentiation of Th0 into Thl and enhances production of Thl cytokine. IL-12 also prevents differentiation of Th0 into Th2 during primary immune response. Its effect on established Th2 cell, however, is well known. OBJECTIVE: The objective of aur study was focused on whether IL-12 prevents recruitment of eosinophil and expression of Th2 cytokine in murine model for bronchial asthma, and whether its effect differs according to timing of dosage. METHOD: Administration of IL-12 was tested in the 3 different time-frames; 1) allergic sensitization (early dosage) 2) allergic challenge (late doaage) or 3) both. The number of eosinophil in the bronchoalveolar lavage(BAL) fluid and tissue was examined for change of airway inflammation. The effect on cytokine expression was assessed by measuring cytokine in bronchoalveolar lavage fluid (ELISA) and mRNA in peribronchial lymph node (RT-PCR) RESULTS: Early dosage of IL-12, and the combination of early and late dosages, strikingly decreased the numbers of eosinophil in both BAL fluid and tissue(p<0.05). Late dosage of IL-12 decreased tissue eosinophilia, while the number of eosinophil in BAL fluid remained unchanged. IL-12 increased IL-4 and IL-5 levels, and decreased IL-2 and I~FN-r levels. There were no differences in Thl/Th2 cytokine regulation among the three dosage times. Early dosage of IL-12, and the combination of early and late dosages, increased IL-10 level, but late dosage had no effect on IL-10. CONCLUSION: These results demonstrate that depending upon whether IL-12 is administered during sensitization or during subsequent allergen exposure, Thl/Th2 cytokine regulation by IL -12 shows no difference because it seems that difference of inhibition of eosinophil recruitment by IL-12 might be related with the other factors, such as IL-10.
Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils ; Inflammation* ; Interleukin-10 ; Interleukin-12* ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Lymph Nodes ; Mice* ; RNA, Messenger ; Th2 Cells

Livedo reticularis is a mottled bluish discoloration of the skin which occurs in a netlike pattern and is not a diagnosis in itself, but is a nonspecific reaction pattern. It may be classified as idiopathic and secondary livedo reticularis. Decompression sickness can occur during decompression after diving into deep sea water or during a rapiid ascent from sea level, and is one of the many causes of the secondary livedo reticularis. We report a case of livedo reticulris which developed in a patient with decompression sickness. A biopsy from the purpuric patch revealed an unusual histopathologic finding that resembles those of bullae and sweat gland necrosis in drug induced coma.
Biopsy ; Coma ; Decompression Sickness* ; Decompression* ; Diagnosis ; Diving ; Humans ; Livedo Reticularis* ; Necrosis ; Seawater ; Skin ; Sweat Glands

Although the incidence of tuberculous arthritis of the hip is being decreased with improvement of hygiene, preventive measures and chemotherapy, it remains as important disease in orthopedic surgery. In the tuberculous arthritis of the hip, eradication of the disease with improvement of joint function is ideal treatment. But classical treatment of anti-tuberculous chemotherapy, synovectomy, and especially hip fusion which was done in most cases in adults, have their own limitation in functional results. Recently the methods of total hip replacement arthroplasty done in tuberculous arthritis with treatment of infection by antituberculous chemotherapy reported good results. During the period from January 1970 to December 1984, total hip replacement arthroplasty were done in 55 patients of tuberculous arthritis of the hip in Seoul National University Hospital. The average follow-up period was 3 years and 1 months. And, the following results were obtained. l. of the 55 cases, 50 cases(90.9%) were resulted in success without reactivation of tuberculosis, and 5 cases(9.1%) were resulted in failure. In those cases, the follow-up period were more than 1 year. 2 . The average period of immediate preoperative anti-tuberculous chemotherapy was higher in the success cases with 10.0 weeks than in the failure cases with 4.5 weeks. 3 . The average preoperative ESR was lower in the success case with 12.4mm/ hr than in the failure cases with 28mm/hr. 4 . Failure cases were restricted to active cold abscess in operative finding. 5. The positive bacteriology was fewer in the success cases with 4% than in the failure cases with 60%. 6. Follow-up functional results of the success cases were superior to any other methods of treatment. It is our conclusion that preoperative anti-tuberculous chemotherapy is important to reduce inflammatous reaction, and although granulation or caseation necrosis is found in operation field, total hip replacement can be successful if there is no active cold abscess.
Abscess ; Adult ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Bacteriology ; Drug Therapy ; Follow-Up Studies ; Hip ; Humans ; Hygiene ; Incidence ; Joints ; Necrosis ; Orthopedics ; Seoul ; Tuberculosis

PURPOSE: To evaluate the functional outcome after surgical treatment for displaced fractures of proximal humerus and assess the final results according to surgical methods. MATERIALS AND METHODS: Thirty-three cases with follow-up over 12 months were divided into three groups: double tension band wiring (Group I, 14), plate fixation (Group II, 10) and closed reduction with internal/external fixation (Group III, 9). The pain index, the self-assessed functional score and the range of motion were obtained. RESULTS: Anatomical reduction was best obtained in group II and fractures united in 11-16 weeks. The pain index was worst in group III and the functional score of group I (80+/-12.2%) was higher than in the others (II: 69+/-15.7%, III: 55+/- 7.9%). The range of motion was worst in group III. Complications were noted in 9 cases, which occurred mostly in group II and III. CONCLUSIONS: Double tension band wiring in displaced proximal humerus fracture demonstrated that it provides a sufficient fixation for early rehabilitation and union, while minimizing complication
Follow-Up Studies ; Humerus* ; Range of Motion, Articular ; Rehabilitation

Many types of meniscal anomalies have been reported. The authors encountered two cases of anomalous insertion of the anterior horn of the medial menisci to the lateral femoral condyle which ran along the course of the anterior cruciate ligament(ACL) without connecting ACL. These anomalies were noted during arthroscopic surgery of the ipsilateral knee for a torn discoid meniscus, and a patellar fracture. A 34-year-old woman had a horizontal tear of the lateral discoid meniscus. We performed arthroscopic partial meniscectomy of the inner torn portion of the lateral discoid meniscus and contoured it to resemble a normal meniscus. An anomalous insertion of the medial meniscus was found on examination of the joint during surgery. A 32-year-old man had a patellar fracture and we performed reduction under arthroscopy and internal fixation with cannulated screws. The same anomalous insertion of the medial meniscus was found on examination of the joint during surgery. We report the cases with review of literature.
Adult ; Animals ; Arthroscopy ; Female ; Horns ; Humans ; Joints ; Knee ; Menisci, Tibial*

BACKGROUND: Pigmented basal cell carcinoma(PBCC) is a clinical and histological variant of BCC, which is known to show better prognosis than non-PBCC. There has been no report about the PBCC among Korean patients. OBJECTIVE: Our purpose was to identify the clinical and histologic characteristics of PBCC and to determine whether this correlated with prognosis. METHODS: A clinical and histological survey was done with 62 lesions of 56 cases of PBCC that visited the Department of Dermatology, Presbyterian Medical Center during the last 10 years(1988 - 1998). Some results were then compared with results of non-PBCC. RESULTS: 1. The frequency of BCC in the total number of new outpatients was 0.34%, and 83.6% of BCC contained pigment histologically. 2. The male-female ratio was 1.24:1, and 92.9% of the patients with PBCC were older than the age of 40 years with the mean age of 62.9 years. 3. 88.7% of the PBCC occurred on the face, especially on the nose(38.7%), cheek(19.4%), and eyelid(17.7%). Clinically, most of the tumors were noduloulcerative(77.4%) and diffuse pigmentation was more common than dotted. 4. The most frequent histologic types were nodulocystic(43.6%) and mixed(43.6%) type followed by superficial(6.4%), micronodular(1.6%), adenoid (1.6%), infiltrative(1.6%), basosquamous(1.6%) types. Histologically 51.6% of the tumors were associated with ulceration, and 71% of the tumors were associated with infiltration of inflammatory cells. 5. Fontana-Masson stains showed pigment is melanin and it was found in both tumor nests and surrounding dermis in most cases(95.0%). Hypertrophic melanocytes with prominent dendrites were seen in the tumor nodule(77.8%) and in the normal epidermis overlying tumor(22.2%). 6. Margins were examined for evidence of residual tumor in 48 lesions that were excised. In 4 lesions(8.3%) were the margin positive for tumor. This was statistically not significant (p>0.05) compared with 10 excisions of non-PBCC in which 2(20%) showed positive margins. CONCLUSION: High incidence of PBCC is a characteristic feature in Korean patients, and PBCC showed better prognosis than non-PBCC because it is more frequently excised with adequate margins.
Adenoids ; Carcinoma, Basal Cell* ; Coloring Agents ; Dendrites ; Dermatology ; Dermis ; Epidermis ; Humans ; Incidence ; Melanins ; Melanocytes ; Neoplasm, Residual ; Outpatients ; Pigmentation ; Prognosis ; Protestantism ; Ulcer

The contusive anterior chamber angle deformities after traumatic hyphema probably were related to the late onset of glaucoma but have been overlooked easily. Authors analysed clinically the angle deformities of 53 patients with traumatic hyphema at the Department of Ophthalmology, Pusan National University from May 1983 to April 1986 by gonioscopic findings. The results were as follows: 1. Male to female ratio of 53 patients was 7.8:1, The average age was 23.7 years. 2. The traumatic hyphema was caused by missile injuries(58.5%) and blunt traumas(41.5%). 3. Of the 53 patients with traumatic hyphema, 42(79.2%) patients had angle recession and 9 patients had normal angle. 4. The degree of angle recession consisted of Grade I, 19.0%(8 cases), Grade II, 38.1%(16 cases), and Grade III, 42.9%(18 cases). The circumferential extent of angle recession increased proportionally with the degree of angle recession. 5. The circumferential extent of angle recession in the range of 271 degrees ~ 360 degrees was 57.1%, 181 degrees ~ 270 degrees was 23.8%, 91 degrees ~ 180 degrees was 11.9% and under 90 degrees was 7.1% of the patients. 6. There was no significant correlation between the amount of hyphema and the extent and degree of angle recession. 7. The distribution of angle recession was noted 42 cases in superonasal quadrant, 34 cases in superotemporal quadrant, 29 cases in inferotemporal quadrant and 23 cases in infercnasal quadrant and was not correlative to the amount of hyphema. 8. Of the 42 patients with angle recession, 35 patients developed peripheral anterior synechiae, its average extent was under 50 degrees, mostly being at the lower half of anterior chamber angle. 9. The relationship between the intraocular pressure and the degree of angle recession was not significant. 10. Associated ocular abnormalities other than angle abnormalities were iris damage(32.1%), chorioretinal damage(17.0%) and lens damage(7.5%). 11. The chorioretinal damage was the major cause of decreased visual acuity. 12. The chronic simple glaucoma was developed in 2(4.8%) of 42 patients with angle recession.
Anterior Chamber* ; Busan ; Congenital Abnormalities* ; Female ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hyphema* ; Intraocular Pressure ; Iris ; Male ; Ophthalmology ; Visual Acuity

The contusive anterior chamber angle deformities after traumatic hyphema probably were related to the late onset of glaucoma but have been overlooked easily. Authors analysed clinically the angle deformities of 53 patients with traumatic hyphema at the Department of Ophthalmology, Pusan National University from May 1983 to April 1986 by gonioscopic findings. The results were as follows: 1. Male to female ratio of 53 patients was 7.8:1, The average age was 23.7 years. 2. The traumatic hyphema was caused by missile injuries(58.5%) and blunt traumas(41.5%). 3. Of the 53 patients with traumatic hyphema, 42(79.2%) patients had angle recession and 9 patients had normal angle. 4. The degree of angle recession consisted of Grade I, 19.0%(8 cases), Grade II, 38.1%(16 cases), and Grade III, 42.9%(18 cases). The circumferential extent of angle recession increased proportionally with the degree of angle recession. 5. The circumferential extent of angle recession in the range of 271 degrees ~ 360 degrees was 57.1%, 181 degrees ~ 270 degrees was 23.8%, 91 degrees ~ 180 degrees was 11.9% and under 90 degrees was 7.1% of the patients. 6. There was no significant correlation between the amount of hyphema and the extent and degree of angle recession. 7. The distribution of angle recession was noted 42 cases in superonasal quadrant, 34 cases in superotemporal quadrant, 29 cases in inferotemporal quadrant and 23 cases in infercnasal quadrant and was not correlative to the amount of hyphema. 8. Of the 42 patients with angle recession, 35 patients developed peripheral anterior synechiae, its average extent was under 50 degrees, mostly being at the lower half of anterior chamber angle. 9. The relationship between the intraocular pressure and the degree of angle recession was not significant. 10. Associated ocular abnormalities other than angle abnormalities were iris damage(32.1%), chorioretinal damage(17.0%) and lens damage(7.5%). 11. The chorioretinal damage was the major cause of decreased visual acuity. 12. The chronic simple glaucoma was developed in 2(4.8%) of 42 patients with angle recession.
Anterior Chamber* ; Busan ; Congenital Abnormalities* ; Female ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hyphema* ; Intraocular Pressure ; Iris ; Male ; Ophthalmology ; Visual Acuity

BACKGROUND: Previous reports have suggested that alleles at the plasminogen activator inhibitor-1 (PAI-1) gene are associated with increased risk of developing coronary artery disease, including myocardial infarction and stroke through their effect on PAI-1 levels. Method: We attempted to search English literatures for all reports of possible effects of PAI-1 gene on cardiovascular disease in human published prior to November 1998. We used a Mantel-Haenszel method (fixed effect model) and random effect model, respectively, to perform a meta-analysis of 7 case-control studies that provided information related to the effects of PAI-1 gene on risk of cardiovascular disease. RESULTS: From 7 studies for diagnosed cardiovascular disease, the relative frequencies of the three genotypes among controls was (5G/5G) (homozygous normal), 24.5%; (4G/5G) (heterozygous), 48.2%, and (4G/4G) (homozygous for the mutant, 675 GGGG), 27.3%. These relative frequencies in cases were 21.7% for 5G/5G, 48.0% for 4G/5G, and 30.3% for 4G/4G. In fixed effect model, compared with those with genotype (5G/5G), the overall odds ratio (OR) for cardiovascular disease among those with (4G/5G) was 1.12 (95% CI, 0.93 to 1.34), and it was 1.20 (1.01 to 1.44) for the (4G/4G) genotype. For five studies with myocardial infarction as the outcome, the overall OR of myocardial infarction was 1.20 (0.99 to 1.47) for those with (4G/5G) and 1.24 (1.00, 1.54) for those with (4G/4G) genotypes, respectively. CONCLUSION: Our findings provide support for the weak association between PAI-1 gene and cardiovascular disease, in particular, myocardial infarction.
Alleles ; Cardiovascular Diseases* ; Case-Control Studies* ; Coronary Artery Disease ; Genotype ; Humans ; Myocardial Infarction ; Odds Ratio ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Polymorphism, Genetic* ; Stroke

Lentigo maligna melanoma(LMM) is the least common type of melanoma and most commonly affects the sun-exposed skin of the elderly. We herein report a case of LMM evolved from lentigo maligna(LM). A 71-year-old female presented with a longstanding irregular brown patch containing two black papules on the left cheek which developed 8 months ago. Histopathologic findings were consistent with LM and LMM. We performed a wide excision and dufourmental flap for reconstruction with no recurrence for 30 months. Sun exposure has been known as the most important etiologic factor for the development of malignant melanoma including LMM and the incidence has an increasing tendency. Thus, skin biopsy is recommended in the evaluation of a longstanding irregular brown patch on the face to prevent LMM.
Aged ; Biopsy ; Cheek ; Female ; Humans ; Hutchinson's Melanotic Freckle* ; Incidence ; Lentigo* ; Melanoma* ; Recurrence ; Skin ; Solar System