BACKGROUND: Tumor necrosis factor(TNF)-alpha and Interleukin(IL)-1beta are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-alpha in the pathogenesis of ARDS, including human studies, it has been reported that TNF-alpha is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-alpha and IL-lbeta as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. METHODS: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood sample were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-alpha and IL-lbeta was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. RESULTS: 1) Plama TNF-alpha levels: Plasma TNF-beta levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the mean+/-2SD, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-alpha levels from patients with ARDS were 10.26pg/mL(median;<10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-alpha levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (P<0.01). There was no statistical significance between survivors(< 10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-alpha levels. 2) Plasma IL-lbeta levels: Plasma IL-1beta levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-1beta levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ng/mL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-19 levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). CONCLUSION: Plasma TNF-alpha and IL-1beta level are not a predictable marker for development of ARDS. But TNF-alpha is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-alpha and IL-1beta in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.
Acute Lung Injury ; Adult* ; Chungcheongnam-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intensive Care Units ; Interleukin-1beta* ; Lung ; Lymphotoxin-alpha ; Necrosis ; Plasma ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Shock ; Shock, Septic ; Tumor Necrosis Factor-alpha*

Thyrotoxic periodic paralysis (TPP) is associated with hypokalemia and occurs sporadically and usually in young adult males. We report ten cases with TPP ; all were males, mean onset age was 32.4 years old. The duration of attack. Varied from 10 to 18 hours. The distribution of paralysis was confined to limb muscles; more severe in proximal limbs and lower extremities. Potassium levels during acute attack correlated with the severity of paralysis and ECG changes, but not with the severity of decrease in TSH level. In all cases, administration of potassium salts was successful in treatment of acute attack. A patient had further attack in spite of euthyroid state under the treatment of thyrotoxicosis for one year. Another patient was free from paralytic attacks by chronic administration of the potassium salt and acetazolamide without treatment of thyrotoxicosis.
Acetazolamide ; Age of Onset ; Electrocardiography ; Extremities ; Humans ; Hypokalemia ; Lower Extremity ; Male ; Muscles ; Paralysis* ; Potassium ; Salts ; Thyrotoxicosis ; Young Adult

The principal objective of this study was to acquire basic data regarding the mycelial growth characteristics for the artificial cultivation of Coprinus comatus. 12 URP primers were employed to evaluate the genetic relationships of C. comatus, and the results were divided into three groups. Among six kinds of mushroom media, MYP medium was selected as the most favorable culture medium for C. comatus. The optimal temperature and pH ranges for the mycelial growth of C. comatus were 23~26degrees C and pH 6~8, respectively. The carbon and nitrogen sources for optimal mycelial growth were sucrose and tryptone, respectively.
Agaricales ; Carbon ; Coprinus ; Cultural Characteristics ; Hydrogen-Ion Concentration ; Nitrogen ; Sucrose

BACKGROUND: The effect of caloric restriction (CR) in the setting of diabetes on bone metabolism has not yet been fully studied. The aim of this study is to determine if short-term CR alters bone mass and metabolism in Otsuka Long-Evans Tokushima fatty (OLETF) rats, an animal model of type 2 diabetes. METHODS: Four groups (n=5) were created: OLETF rats with food ad libitum (AL), OLETF rats with CR, Long-Evans Tokusima Otsuka (LETO) rats with food AL, and LETO rats with CR. The CR condition was imposed on 24-week-old male rats using a 40% calorie reduction for 4 weeks. The effect of CR on femoral bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry. Serum markers were measured by immunoassay. RESULTS: After 4 weeks of CR, body weight decreased in both strains. The BMD decreased in LETO rats and was maintained in OLETF rats. After adjustment for body weight, BMD remained lower in LETO rats (P=0.017) but not OLETF rats (P=0.410). Bone-specific alkaline phosphatase levels decreased in LETO rats (P=0.025) but not in OLEFT rats (P=0.347). Serum leptin levels were reduced after CR in both strains, but hyperleptinemia remained in OLETF rats (P=0.009). CR increased 25-hydroxyvitamin D levels in OLETF rats (P=0.009) but not in LETO rats (P=0.117). Additionally, interleukin-6 and tumor necrosis factor-alpha levels decreased only in OLETF rats (P=0.009). CONCLUSION: Short-term CR and related weight loss were associated with decreases of femoral BMD in LETO rats while BMD was maintained in OLETF rats. Short-term CR may not alter bone mass and metabolism in type 2 diabetic rats.
Absorptiometry, Photon ; Alkaline Phosphatase ; Animals ; Body Weight ; Bone Density* ; Caloric Restriction* ; Diabetes Mellitus, Type 2 ; Humans ; Immunoassay ; Interleukin-6 ; Leptin ; Male ; Metabolism ; Models, Animal ; Rats* ; Rats, Inbred OLETF ; Tumor Necrosis Factor-alpha ; Weight Loss ; Biomarkers

Two case reports discussing Korean ginseng-induced allergic reactions have been published; both were inhalation-induced respiratory allergies in occupational settings. In this report we discuss the first case of anaphylaxis that developed after an oral intake of ginseng, confirmed by an open oral challenge, a skin prick test (SPT), and a basophil activation test (BAT). A 44-year-old man experienced rhinorrhea and nasal stiffness, followed by respiratory difficulty with wheeze and abdominal pain 10 minutes after oral intake of fresh ginseng. He had suffered from episodes of allergic rhinitis during the spring season for several years. Upon presentation, a physical examination, chest radiograph, and routine laboratory tests were unremarkable. Total serum IgE level was 41 IU/mL. The SPT results showed strong positive responses to alder, birch pollens, and ginseng extracts (1:500 w/v). The methacholine bronchial challenge test revealed a positive result at PC20 of 5.83 mg/mL. The open oral challenge was performed using 50 g of fresh ginseng and showed immediate onset of facial flushing, cough, respiratory difficulty with wheeze, and abdominal pain combined with a significant decrease in FEV1 levels (54% from the baseline). Serum-specific IgE and IgG4 antibodies were not detectable by enzyme-linked immunosorbent assay. BAT showed a remarkable increase in the expression of CD203c and CD63 with the addition of ginseng extract in a dose-dependent manner, while no changes were noted in the controls. In conclusion, oral intake of Korean ginseng could induce anaphylaxis, which is mediated by non-IgE-dependent direct activation of basophil/mast cells.
Abdominal Pain ; Adult ; Alnus ; Anaphylaxis ; Antibodies ; Basophils ; Betula ; Bronchial Provocation Tests ; Cough ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Flushing ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Methacholine Chloride ; Panax ; Physical Examination ; Pollen ; Rhinitis ; Rhinitis, Allergic, Perennial ; Seasons ; Skin ; Thorax

Pseudomyxoma Peritonei is a condition in which, as a result of ruptured mucinous tumors of the ovary or appendix, the peritoneal surface and omentum are involved with mucin secreting cells. This is a rare disease which occurs predominantly in middle aged women, characterized by histologically benign but whicth is clinically malignant. We have experienced a case of Pseudomyxoma Peritonei due to rupture of borderline mucnous tumor of the ovary and report with a brief review of literatures.
Appendix ; Female ; Humans ; Middle Aged ; Mucins ; Omentum ; Ovary ; Pseudomyxoma Peritonei* ; Rare Diseases ; Rupture

Alagille syndrome is a complex autosomal dominant disorder secondary to defects in the Notch signaling pathway, primarily caused by mutations in the Jagged1 (JAG1) gene. The liver, heart, skeleton, face and eyes are the body parts most commonly involved. Alagille syndrome may mimic other causes of high gamma-glutamyl transferase (GGT)-linked cholestasis, most notably biliary atresia in the neonatal period. Infants with Alagille syndrome are occasionally misdiagnosed as cases with biliary atresia due to variations in clinical features that might be expressed in early infancy. We describe a case of Alagille syndrome mimicking biliary atresia, identified by sequencing analysis of the JAG1 gene in a newborn. During counseling, family members of the patient have also been found to demonstrate various phenotypes and levels of disease severity of Alagille syndrome.
Alagille Syndrome* ; Biliary Atresia* ; Cholestasis ; Counseling ; Heart ; Human Body ; Humans ; Infant ; Infant, Newborn* ; Liver ; Phenotype ; Skeleton ; Transferases

Interstitial lung disease (ILD) with autoantibodies against antisynthetase may occur in the absence of clinically apparent myositis. We report 58-year-old woman who initially presented with dyspnea. The patient showed positive immunologic markers reflecting systemic lupus erythematosus, destructive polyarthritis, Raynaud's phenomenon, and ILD. There is no proximal muscle weakness in her symptoms. This syndrome was confirmed by positive antibodies to Jo-1. For the early diagnosis of this syndrome, the possibility of this syndrome including other connective tissue disease should be considered in patients presenting with symptoms related to ILD and positive anti-nuclear antibody.
Antibodies ; Arthritis ; Autoantibodies ; Biomarkers ; Connective Tissue Diseases ; Dyspnea ; Early Diagnosis ; Female ; Humans ; Lung Diseases, Interstitial ; Lupus Erythematosus, Systemic* ; Middle Aged ; Muscle Weakness ; Myositis

OBJECTIVE: To assess prosthetic use by upper extremity amputees, and their difficulties with prostheses in activities of daily living and occupations. METHOD: This study is based on a survey of 307 subjects, who were using prostheses manufactured in the Center of Prosthetics and Orthotics. The survey questionnaire included items about general demographic characteristics, side and level of amputation, type of prosthesis and its use, and difficulties in the activities of daily living, employment and driving. RESULTS: The most common type of prosthesis was the cosmetic hand type (80.2%). There were no statistically significant correlations between satisfaction with prosthesis and the amputation level or type of prosthesis. The most common difficulties in daily living activities experienced by amputees were lacing shoes, removing bottle-tops with a bottle opener, and using scissors. Only 7.3% of amputees received rehabilitation services. Less than half of the amputees (44.7%) used their prostheses for eight or more hours a day, and 76.9% used their prostheses for regular or irregular cosmetic purposes. After amputation, most of the respondents (69.0%) became unemployed or changed workplaces. CONCLUSION: In our study, respondents preferred cosmetic usage to functional usage. Only 30.0% of respondents reported satisfaction with their prostheses. Many of the amputees had difficulties in complex tasks and either changed jobs or became unemployed. Clerical workers were the occupation group, which was most likely to return to work. The development of a more functional prosthetic hand and additional rehabilitation services are required.
Activities of Daily Living ; Amputation ; Amputees ; Cosmetics ; Surveys and Questionnaires ; Employment ; Hand ; Humans ; Occupations ; Prostheses and Implants ; Return to Work ; Shoes ; Upper Extremity ; Surveys and Questionnaires

OBJECTIVE: We assessed the characteristics of Capgras syndrome in patients diagnosed as probable Alzheimer disease, and compared the clinical and imaging findings with other previous reports. METHODS: We obtained medical records of patients with Capgras syndrome diagnosed as probable Alzheimer disease in three hospitals from March 2009 to March 2010. The basic characteristics, neuropsychologic tests, brain imaging data were investigated. RESULTS: The mean age of the patients was 74.7 years old and all of the patients experienced this syndrome in relation to a spouse. Brain magnetic resonance imaging showed mild-to-moderate global atrophy, variable hippocampal atrophy in this study. The Mini-Mental State Examination mean scores were 18.78 and clinical dementia rating scores were from 1 to 2. All of the patients took medicine of acetycholine esterase inhibitors and two patients recovered with antipsychotic medication. Five patients had showed continuous Capgras syndrome, at the last follow-up day, for a year. CONCLUSION: Capgras syndrome patients in this study who were diagnosed as probable Alzheimer disease showed similar results to the individuals from other reports. More study is needed to estimate the numbers and characteristics of patients with this syndrome.
Alzheimer Disease ; Atrophy ; Brain ; Capgras Syndrome ; Dementia ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neuroimaging ; Neuropsychological Tests ; Spouses