BACKGROUND: Normal humans meet the increased ventilatory need during exercise initially by the increase of tidal volume (TV) and later by the increase of respiratory frequency (Rf). And the inspiratory duty cycle (Ti/Ttot) is also increased more than 50% for the compensation of the decrease of respiratory cycle provoked by the increase of respiratory frequency. The patients with chronic airflow obstruction show rapid and shallow breathing pattern during exorcise because of the degreased ventilatory capacity and the increased dead space ventilation. However, the studies about the change of inspiratory duty cycle are only a few and there is no literature about the relationship between the change of inspiratory duty cycle and the degree of airflow obstruction. METHODS: The subjects were the twelve patients with chronic airflow obstruction (CAO) and ten normal people. The incremental exercise test was done. The increase of work load was 10 Win CAO group and 25 Win normal control group. The analysis of the results was done by the comparison of the parameters such as minute ventilation (VE), TV, Rf, physiologic dead space (Vd/vt), and inspiratory duty cycle between the two groups. Each parameters were compared after transformation into % control duration base that means dividing the total exercise time into five fractons and % control duration data were obtained at rest, 20%, 40%, 60%, 80%, and max. Statistical analysis was done by repeated measure ANOVA using SAS program. RESULTS: The changes of VE and TV were significantly different between two groups while the change of Rf was not significant. The decrease of Vd/vt was significantly low in CAO group. Ti/Ttot was markedly increased from 38.4+3.0% at rest to 48.6+4.5% at max in normal control group while Ti/Ttot showed little change from 40.5+2.2% at rest to 42.6+3.5% at max. And the change of inspiratory duty cycle showed highly good correlation with the degree of airflow obstruction (FEVl%). (r=0.8151, p<0.05) CONCLUSIONS: The increase of Ti/Ttot during exercise observed in normal humans is absent in the patients with CAO and the change of Ti/TtDt is well correlated with the degree of airflow obstruction.
Compensation and Redress ; Exercise Test* ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Respiration* ; Tidal Volume ; Ventilation

Histoid leproma usually occur in pat.ients with lepromatous leproy who have had relapsed after being undcr treatment(usually sulfones) for a long time and who have shown variable improvement. A 56 year old female patient who had been suffering from lepromatous leprosy and had been treated which clapsone relatively regularly for approximately 28 years had a history of several shiny rice grain t.o peanut sized nodules on the face and right flank. Histopathologic examination of a specimen taken from a nodular lesian revealed a well circirmscrihed nodule composed mainly of spindle-shaped cells and epithe:ioi 1 cells on the upper and mid-levmis, and granuloma composed of epithelioid cells, multinucleated wait cells and foamy histiocytes on the lower dermis. In AFB stain, numerous acid-fast bacilli were scatt red dermis and epidermis, especially stratum corneum. This study opplied a polymease chain reaction(PCR) on sections of biopsy tissues and peripheral blood of pat.ient. Positive amplification of a 530 bp fragment was deteated not only in the lesion tissues but also in the per ipher al blood.
Biopsy ; Edible Grain ; Dermis ; Epidermis ; Epithelioid Cells ; Female ; Granuloma ; Histiocytes ; Humans ; Leprosy, Lepromatous ; Middle Aged ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction*

Leukemia cutis is defined as infiltration of the skin by malignant leukocytes that have originated from the bone marrow. The cutaneous eruption of leukcmia may be divided into the specific and non-specific lesion (leukemid). These may occur separately or in combination. True leukemia infiltrations of the skin consist of nodular, diffuse, or plaque-like infiltrations with swelling, macules, papules, ecchymoses, palpable purpura, erythroderma, and ulceration. A 55-year-old man presented with multiple as mptomatic dark-brown nodules on the whole body with recurrent gingival bleeding. The patient developed seoticemia and died 6 months after the onset of the disease.
Bone Marrow ; Dermatitis, Exfoliative ; Ecchymosis ; Hemorrhage ; Humans ; Leukemia* ; Leukocytes ; Middle Aged ; Purpura ; Skin ; Ulcer

Squamous cell carcinoma of the lower lip can be developec by a number of underlying etiologic factors, the most outstanding of which is solar irracdiation, and is considerably more aggresive and has a much higher incidence of metastatic spread. Its early detection and effective treatment afford a high cure rate. Cryosurgery is a simple, efficient and effective method of treatment of skin cancer and is now a widely accepted modality for the treatment of these lesions. Two patients(67-year-old male and 57-year-old female) were presented with solitary or two masses on the lower lip without regional lymphadenopathy. These two cases showed clinical and histopathologic findings of squamous cell carcinoma. They were successfully treated by cryotherapy with liquid nitrogen without any significant side effects.
Carcinoma, Squamous Cell ; Cryosurgery ; Cryotherapy ; Humans ; Incidence ; Lip* ; Lymphatic Diseases ; Male ; Middle Aged ; Nitrogen* ; Skin Neoplasms

BACKGROUND: IL-8 is a potent chemotactic cytokine that plays an important role in the host defense mechanism against M. tuberculosis by recruiting inflammatory cells to the site of the infection. Lung epithelial cells, as well as alveolar macrophages are known to preduce IL-8 in response to M. tuberculosis. IL-8 gene expression is mainly regulated on the level of transcription by NF-κB. This study investigated whether or not A549 cells produce IL-8 in NF-κB dependent mechanism in response to macrophages phagocytosing M. tubersulosis. METHODS: Peripheral blood monocytes that were obtained from healthy donors were cultured for 24 h with M. tuberculosis and a conditioned medium(CoMTB) was obtained. As a negative control, the conditioned medium without M. tuberculosis (CoMCont) was used. A549 cells were stimulated with M. tuberculosis, CoMCont and CoMTB and the IL-8 concentration in the culture media was measured by ELISA. The CoMTB induced IL-8 mRNA expression in the A549 cells was evaluated using RT-PCR, and CoMTB induced IκBα degradation was measured using western blot analysis. CoMTB induced nuclear translocation and DNA binding of NF-κB was also examined using an electrophoretic mobility shift assay(EMSA), and the CoMTB induced NF-κB dependent IL-8 transcriptional activity was measured using a luciferase reporter gene assay. RESULTS: CoMTB induced IL-8 production by A549 cells(46.8±4.8 ng/ml) was higher than with direct stimulation with M. tuberculosis (6.8±2.9 ng/ml). CoMTB induced IL-8 mRNA expression increased after 2 h of stimulation and was sustained for 24 h. IκBα was degraded after 10 min of CoMTB stimulation and reappeared by 60 min. CoMTB stimulated the nuclear translocation and DNA binding of NF-κB. The CoMTB induced NF-κB dependent IL-8 transcriptional activity(13.6±4.3 times control) was higher than either CoMCont(2.0±0.6 times control) or M. tuberculosis (1.4±0.6 times control). CONCLUSION: A conditioned medium of peripheral blood monocytes phagocytosing M. tuberculosis stimulates NF-κB dependent IL-8 production by the lung epithelial cells.
Blotting, Western ; Culture Media ; Culture Media, Conditioned ; DNA ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression ; Genes, Reporter ; Humans ; Interleukin-8* ; Luciferases ; Lung* ; Macrophages ; Macrophages, Alveolar ; Monocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; Tissue Donors ; Tuberculosis

BACKGROUND: Methods to detect and quanitify Mycobacterium leprae(M. leprae)are needed for studies involving the epidemiology, pathogenesis, and chemotherapy of leprosy. Serological assays and skin tests lack the sensitivity and specificity to serve as diagnostic tool for M. leprae infection. The polymerase chain reaction(PCR) based on the selective amplification of an 530-bp frangment of the gene encoding the proline-rich antigen of M. leprae was performed with sections of fixed or frozen biopsy samples from leprosy patients. OBJECTIVE: This study was done to investigate the applicability of PCR for the detection of low numbers of M. leprae in tissues and peripheral blood. METHODS: The PCR was used to amplify a 530-base-pair M. leprae DNA with the thermoxtable Taq DNA polymerase. RESULTS: The In frozen skin tissues and peripheral blood of leprosy patients. relatively high detection rates of PCR products was achieved by using direct gel analysis as well as Southern blot hybridization. CONCLUSION: These results suggest that PCR amplification for the detection of M. leprae may be useful for the epidemiologic study of large papulations as well as coinical astudies on the individual patients.
Biopsy ; Blotting, Southern ; DNA ; Drug Therapy ; Epidemiologic Studies ; Epidemiology ; Humans ; Leprosy ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin ; Skin Tests ; Taq Polymerase

Cutaneous manifestations of Vibrio vulnificus septicemia are bullae, vesicles, necrotic ulcers, localized swelling, cyanosis, and gangrene, which begin to occur mostly on the legs. The characteristic cutaneous lesions associated with pain often give an informative clue for the suspicion of Vibrio vulnificus infection in endemic area. We report a case of Vibrio vulnificus septicemia with atypical cutaneous manifestation of generalized erythema multiforme-like eruption in a Korean man, who died within 9 hours following hospitalization in spite of the intensive therapy. We suggest EM-like eruption of V. vulnificus septicemia is the novel cutaneous manifestation and may indicate poor prognosis.
Cyanosis ; Erythema* ; Gangrene ; Hospitalization ; Leg ; Prognosis ; Sepsis* ; Ulcer ; Vibrio vulnificus* ; Vibrio*

No abstract available.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Korea*

BACKGROUND: Epidural steroids injections are often used for the treatment of low back pain but their effects on the endocrine system have not been determined. Few studies have quantified the degree or duration of the suppression of the hypothalamic-pituitary-adrenal (HPA) axis in humans given epidural triamcinolone injection (ETI) for low back pain. The evaluation of the blood adrenocorticotropic hormone (ACTH) and cortisol was undertaken to determine the extent of suppression of the HPA axis in patients given ETI. METHODS: Lumbar epidural triamcinolone injections were performed on the painful lumbar intervertebral space with patients in the lateral decubitus position. The injection consisted of 40 mg of triamcinolone acetonide diluted in 10 mL of 1% lidocaine. Patients remained in the lateral position for 10 min after the procedure. Basal blood sampling was performed at 30 min before ETI and tested blood sampling was obtained at 7 days, 10 days, and 14 days after ETI. RESULTS: The blood cortisol level was significantly decreased at 7 days and 10 days but at 14 days was not significantly decreased and the blood ACTH level was not significantly decreased at 7 days, 10 days, and 14 days. CONCLUSIONS: Above results demonstrate that blood ACTH and cortisol level normalize 7 days and 14 days, respectively, after epidural triamcinolone 40 mg injection.
Adrenocorticotropic Hormone* ; Axis, Cervical Vertebra ; Endocrine System ; Humans ; Hydrocortisone* ; Lidocaine ; Low Back Pain ; Steroids ; Triamcinolone Acetonide ; Triamcinolone*

We report a case of angiocentric lymphoma in a 41-year-old female who complained chiefly of a genital ulcer and a bulging conjunctiva on the right eye. She had a history of a re-current oral ulcer over a 5 year period and a genital ulcer over 3 years. The above manifested clinical findings may suggest Behcet's disease. However, a biopsy from the upper vaginal wall and the inferior turbinate showed that atypical small and large lymphocytes with hyper-chromatic, elongated and convoluted nuclei had aggregated around the thickened blood vessels, which is consistent with angiocentric lymphoma. Immunophenotypically, the atypical cells were positive for pan T-cell markers not B-cells. Serologically, the patient showed a high titer of i?B virus viral capsid antigen(VCA) IgG.
Adult ; B-Lymphocytes ; Biopsy ; Blood Vessels ; Capsid ; Conjunctiva ; Female ; Humans ; Immunoglobulin G ; Lymphocytes ; Lymphoma* ; Oral Ulcer ; T-Lymphocytes ; Turbinates ; Ulcer