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

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

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

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*

Sixty-four eyes in 65 patients received prophylactic treatment for retinal break and predisposing degeneration. During the follow-up period of 6 months or more, rhegmatogenous retinal detachment occurred in 2 eyes(3.0%). In one aphakic eye, new tear was responsible for the subsequent formation of retinal detachment but in the other eye, retinal detachment resulted from inadequate reaction around the treated retinal tear. One patient with bilateral multiple tears developed new retinal tear without detachment. Except these cases, no intra-or permanent post-operative complications were noticed.
Follow-Up Studies ; Humans ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde*

No abstract available.
Gallstones* ; Lithotripsy* ; Ultrasonography*

Tumor suppressive effect of dehydroepiandrosterone (DHEA) on the experimentally induced hepatocellular carcinoma was investigated, especially focusing on glutatione transferase and transglutaminase with aptosis in the carcinogenesis. The chemical hepatocarcinogenic procedure of Solt-Farber method was used on Sprague-Dawley rats. Experimental groups were divided into AA group treated by the standard Solt-Farber regimen of diethylnitrosamine (DEN) and 2-acetamidofluorene (AAF) and AD group treated with DHEA simultaneously with AAF and the AAD group treated by DHEA after treatment with AAF. Each group was divided by time sequence further into four subgroups, GI (8wk), G2 (16wk), G3 (28wk), and G4 (36wk). For neoplastic lesion, the immuno histochemical study with anti GSTP antibody was carried out, while the activity and expression of TGase was compared at the same time. The results were summarized as follows; GST-P positive foci detected in AD groups were significantly more suppressed by DHEA treatment than AA groups (P<0.05). AD groups. AD group showed higher activities of TGase than AA groups (P<0.05), which was confirmed by Western and Northern blot analysis. But the number of apoptotic bodies was not correlated with activity and expression of TGase in the nodule. These results suggest that the suppressive effect of DHEA on the murine hepatocellular carcinogenesis might be operating on the promotion process of carcinogenesis rather than regression process of transformed hyperplastic nodules.
Carcinoma, Hepatocellular

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

BACKGROUND: Although rubella is a mild exanthematous viral infection and its incidence has been greatly decreased after effective vaccination, epidemics of rubella has been noted at 5- to 7-year intervals. But there has been few report about the clinical and histopathologic study of rubella in Korean literatures. OBJECTIVE: The purpose of this study was to review the clinical and histopathologic characteristics of rubella of 1996 outbreak. METHODS: We reviewed the clinical features and histopathologic findings in 50 patients diagnosed as rubella in Department of Dermatology, Presbyterian Medical Center from January 1996 through to May 1996. RESULTS: 1. The male-female ratio was 1: .17. The age distribution was 13-32 years and 72% of patients were aged 16-25 years. 2. Erythematous maculopapular rash on whole body was developed in all patients. Eighty two percent of the patients had fever and lymphadenopathy, and 36% of the patients had petechiae of soft palate. The main prodromal symptoms were sore throat(50%), headache(34%), and upper respiratory symptoms(22%), as order of frequency. 3. Positive serologic test for rubella IgM antibody was 79.5%. 4. The most common abnormal laboratory finding was leukopenia(58%), and followed by positive ASO(34%), the presence of atypical lymphocytes(21%), and thrombocytopenia(8%). 5. Histologically, epidermal changes were mild to moderate vacuolopathy(92.3%), the presence of dyskeratotic cells(30.8%), spongiosis(23.1%), and exocytosis(15.4%). Dermal findings were mild superficial perivascular lymphohistiocytic infiltration(100%), upper dermal edema(53.8%), perivascular edema(38.4%), pigmentary incontinence(30.8%), and the presence of extravasated RBC(23.1%). Eosinophil infiltration(15.4%) and the presence of large nucleated lymphocytes(92.3%) were also observed. Conclusions: According to the results of our study about rubella outbreak in 1996, clinical signs and symptoms were similar to those of previously described. Histologically, superficial perivascular dermatitis with mild to mederate vacuolar interface change was a main feature and large nucleated lymphocytes were frequently noted.
Age Distribution ; Dermatitis ; Dermatology ; Eosinophils ; Exanthema ; Fever ; Humans ; Immunoglobulin M ; Incidence ; Lymphatic Diseases ; Lymphocytes ; Palate, Soft ; Prodromal Symptoms ; Protestantism ; Purpura ; Rubella* ; Serologic Tests ; Vaccination