Epidemiological data of Bordetella pertussis infection among adolescents and adults are limited in Korea. Patients (> or = 11 yr of age) with a bothersome cough for less than 30 days were enrolled during a 1-yr period at 22 hospitals in Korea. Nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and for bacteriologic culture. In total, 490 patients were finally enrolled, and 34 (6.9%) patients tested positive for B. pertussis; cough duration (14.0 days [7.0-21.0 days]) and age distribution were diverse. The incidence was the highest in secondary referral hospitals, compared to primary care clinics or tertiary referral hospitals (24/226 [10.6%] vs. 3/88 [3.4%] vs. 7/176 [4.0%], P = 0.012), and the peak incidence was observed in February and August (15.8% and 15.9%), with no confirmed cases between March and June. In the multivariate analysis, post-tussive vomiting was significantly associated with pertussis (odds ratio, 2.508; 95% confidence interval, 1.146-5.486) and secondary referral hospital showed a borderline significance. In conclusion, using a PCR-based method, 6.9% of adolescent and adult patients with an acute cough illness had pertussis infection in an outpatient setting. However, hospital levels and seasonal trends must be taken into account to develop a better strategy for controlling pertussis.
Adolescent ; Adult ; Bordetella pertussis/*genetics ; Child ; DNA, Bacterial/*analysis ; Demography ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; *Polymerase Chain Reaction ; Republic of Korea/epidemiology ; Seasons ; Vomiting/etiology ; Whooping Cough/*epidemiology/microbiology/pathology ; Young Adult

In this study, we investigated profiles of the cytokines IFN-g, IL-12, and IL-10 in active pulmonary tuberculosis (EAPTB) patients, HIV-negative patients with multidrug-resistant tuberculosis (MDR-TB) and in healthy tuberculin reactors (HTR). We studied the responses of peripheral blood mononuclear cells (PBMC) from 12 EAPTB patients and 15 MDR-TB patients to stimulation with a purified protein derivatives (PPD) antigen (Ag), and compared them with those from 14 HTR. Using ELISA, IFN-g production was found to be significantly depressed, while IL-10 was significantly elevated in both MDR-TB and EAPTB after in vitro stimulation with PPD, compared with those in HTR. Although there was no significant difference in IL-12 production among the three groups, mean IL-12 production was highest in patients with MDR-TB. In these patients, IL-12 production was significantly correlated with IL-10 expression, but not IFN-g production. In addition, neutralization of endogenous IL-10 led to enhanced IFN-g and IL-12Rb2 mRNA expression in TB patients. Our findings suggest that both groups of TB patients may have a similar disregulated pattern of IL-12, IL-10, and IFN-g production during M. tuberculosis infection. Furthermore, the results suggest a potentially pathogenic role for IL-10 in impaired Th1 immune responses in TB patients.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interferon-gamma ; Interleukin-10* ; Interleukin-12* ; Mycobacterium tuberculosis ; RNA, Messenger ; Tuberculin ; Tuberculosis ; Tuberculosis, Multidrug-Resistant* ; Tuberculosis, Pulmonary

BACKGROUND: Our previous study showed that purified protein derivative (PPD)- stimulated pleural mononuclear cells (PMC) from tuberculous pleurisy (Tbp) produced significantly more IFN-gamma (10- to 70-fold) after in vitro PPD stimulation than freshly isolated pleural cells from malignant pleurisy. The present study was designed to determine whether blocking the CD40-CD40 ligand (CD40L) interaction decreases IFN-gamma production by altering IL-12 levels. METHODS: IL-12 and IFN-gamma production after neutralizing anti-CD40L antibody treatment was compared to the efficacy of anti-CD80, anti-CD86, and a combination of anti-CD80 and CD86 (CD80+86) monoclonal antibodies (mAb). These activities were measured by enzyme-linked immunosorbent assays (ELISAs) and reverse transcription-polymerase chain reaction (RT-PCR), after in vitro stimulation with PPD antigen (Ag). RESULTS: Neutralization of CD80, CD86 and CD80+86 did not decrease IFN-gamma and IL-12 production in Tbp-PMC, whereas neutralization of CD40L significantly depressed IL-12 p40 and IFN-gamma. In addition, neutralization of CD40L completely inhibited IL-12 p40 and IFN-gamma mRNA expression. CONCLUSION: The CD40-CD40L interaction might play a major role in IL-12 and IFN-gamma production in Tbp-PMC, thus contributing to protective immunity in human tuberculosis.
Antibodies, Monoclonal ; CD40 Ligand ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-12* ; Pleurisy ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pleural

BACKGROUND: Our previous study showed that purified protein derivative (PPD)- stimulated pleural mononuclear cells (PMC) from tuberculous pleurisy (Tbp) produced significantly more IFN-gamma (10- to 70-fold) after in vitro PPD stimulation than freshly isolated pleural cells from malignant pleurisy. The present study was designed to determine whether blocking the CD40-CD40 ligand (CD40L) interaction decreases IFN-gamma production by altering IL-12 levels. METHODS: IL-12 and IFN-gamma production after neutralizing anti-CD40L antibody treatment was compared to the efficacy of anti-CD80, anti-CD86, and a combination of anti-CD80 and CD86 (CD80+86) monoclonal antibodies (mAb). These activities were measured by enzyme-linked immunosorbent assays (ELISAs) and reverse transcription-polymerase chain reaction (RT-PCR), after in vitro stimulation with PPD antigen (Ag). RESULTS: Neutralization of CD80, CD86 and CD80+86 did not decrease IFN-gamma and IL-12 production in Tbp-PMC, whereas neutralization of CD40L significantly depressed IL-12 p40 and IFN-gamma. In addition, neutralization of CD40L completely inhibited IL-12 p40 and IFN-gamma mRNA expression. CONCLUSION: The CD40-CD40L interaction might play a major role in IL-12 and IFN-gamma production in Tbp-PMC, thus contributing to protective immunity in human tuberculosis.
Antibodies, Monoclonal ; CD40 Ligand ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-12* ; Pleurisy ; RNA, Messenger ; Tuberculosis ; Tuberculosis, Pleural

PURPOSE: To evaluate the relationship between the expressions of p53, bcl-2, bax, and p-glycoprotein and the chemotherapeutic response seen in patients with advanced NSCLC. MATERIALS AND METHODS: Forty-four patients pathologically proven as NSCLC were reviewed. They had undergone at least two cycles of the same chemotherapeutic agents (cisplatin 60 mg/m2 day 1+ vinorelbine 25 mg/m2 day 1, 8, 21-day cycle) and the clinical response was evaluated by WHO criteria. The expressions of p53, bcl-2, bax, and p-glycoprotein were determined by immunohistochemistry. RESULTS: Patients recorded as CR (2/44) and PR (20/44) were classified as the responder group (22/44) and stable (17/44) and progression (5/44) as the non-responder group (22/44). Positive expression of p53, bcl-2, bax, and p-glycoprotein were 84.1%, 65.9%, 88.6%, and 61.4% respectively. The expression score of p53 was significantly higher in the non-responder group than that seen in the responder group (8.59+/-1.89 vs 5.32+/-2.15, p<0.05). However, the expression scores of bcl-2, bax, and p-glycoprotein were not significantly correlated with the clinical response. CONCLUSION: This study suggests that p53 gene mutation plays an important role in the clinical response to chemotherapy including cisplatin and vinorelbine. In future investigations, the correlation with the survival time will be studied.
Cisplatin ; Drug Therapy ; Genes, p53 ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Lung* ; P-Glycoprotein*

Nonspecific interstitial pneumonia (NSIP) was first described as a new category of idiopathic interstitial pneumonia in 1994. This is a disease with a more insidious onset and has a chronic course. The histological findings are unusual for other idiopathic interstitial pneumonia cases (usual interstitial pneumonia, diffuse interstitial pneumonia, and acute interstitial pneumonia). In contrast to NSIP, acute interstitial pneumonia (AIP) has an acute onset and a fulminant course with the rapid development of respiratory failure. A pathological examination demonstrated characteristic diffuse interstitial fibrosis, hyaline membranes, thrombi, and architectural derangement. Here we report a 48-year-old woman who was diagnosed pathologically NSIP, but with a rapid progressive course similar to AIP.
Female ; Fibrosis ; Humans ; Hyalin ; Idiopathic Interstitial Pneumonias ; Lung Diseases, Interstitial* ; Membranes ; Middle Aged ; Respiratory Insufficiency

In this study, we investigated interleukin (IL)-18 and IL-12 following in vitro stimulation with either the 30-kDa or purified protein derivative (PPD) antigens (Ag) of pleural mononuclear cells from 12 cases of tubercular pleurisy (TB-PMC) and 8 cases of malignant pleurisy (MG-PMC). Ag-stimulated TB-PMC produced significantly more IL-12 than did MG-PMC and the levels correlated with those of IFN - gamma. Although elevated IL-18 levels were found in freshly isolated pleural fluids, in vitro IL-18 production in response to either Ag was dramatically decreased in TB-PMC. Pro-IL-18 mRNA was detected before and after Ag stimulation in TB patients. Supernatants from the Ag-stimulated TB-PMC significantly suppressed IL-18 production in normal peripheral blood mononuclear cells (PBMC) and primary malignant cells over an 18 h incubation period. In addition, this suppressive activity was not inactivated by either heat or trypsin. Our findings imply that modulation of IL-12 and IL-18 levels may contribute to the Th1 elevation induced in human TB-P VIC by the 30-kDa and PPD antigens.
Hot Temperature ; Humans ; Interleukin-12* ; Interleukin-18* ; Interleukins ; Mycobacterium tuberculosis ; Pleurisy ; RNA, Messenger ; Trypsin ; Tuberculosis, Pleural

PURPOSE: To determine the therapeutic effect and toxicities of cisplatin and vinorelbine combination chemotherapy in patients with inoperable non-small-cell lung cancer. MATERIALS AND METHODS: Between Jan 1998 and Dec 1999, 28 patients with inoperable non- small-cell lung cancer were treated with cisplatin and vinorelbine combination chemotherapy as induction treatment. A combination of vinorelbine 25 mg/m2 day 1,8 and cisplatin 60 mg/m2 day 1 were given and repeated every 3 weeks. Then we assessed response and toxicity according to WHO grades. RESULTS: According to response criteria, there were 1 complete response, 12 partial response (42.9%), 12 stable disease (42.9%), and 3 progression (10.7%). The median survival was 12 months. According to toxicity grades, 24 grade 3 myelosuppression (24.7%), 12 grade 4 myelo suppression (10.7%), 6 grade 3 and 4 constipation (6.1%), and mild 7 (7.2%) thrombophlebitis were experienced in evaluable 97 cycles. There was no other clinically severe toxicity. CONCLUSION: These results suggest that combination chemotherapy with cisplatin and vinorelbine in patients with inoperable non-small-cell lung cancer was effective and safe.
Cisplatin* ; Constipation ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Lung Neoplasms* ; Lung* ; Thrombophlebitis

No Abstract Available.
Humans ; Interleukin-12* ; Interleukin-18* ; Tuberculosis, Pleural*

BACKGROUND: Massive and untreated hemoptysis is associated with a mortality of greater than 50 percent. Since the bleeding is from a bronchial arterial source in the vast majority of patients, embolization of the bronchial arteries(BAE) has become an accepted treatment in the management of massive hemoptysis because it achieves immediate control of bleeding in 75 to 90 percent of the patients. METHODS: Between 1990 and 1996, we treated 146 patients with hemoptysis by bronchial artery embolization. Catheters(4, 5, or 7F) and gelfoam, ivalon, and / or microcoil were used for embolization. RESULTS: Pulmonary tuberculosis and related disorders were the most common underlying disease of hemoptysis(72.6%). Immediate success rate to control bleeding within 24hours was 95%, and recurrence rate was 24.7%. The recurrence rate occured within 6 months after embolization was 63.9%. Initial angiographic findings such as bilaterality, systemic-pulmonary artery shunt, neovascularity, aneurysm were not statistically correlated with rebleeding tendency(P>0.05). Among Initial radiographic findings,only pleural lesions were significantly correlated with rebleeding tendency(P<0.05). At additional bronchial artery angiograpy done due to rebleeding, recanalization of previous embolized arteries were 63.9%, and the presence of new feeding arteries were 16.7%, and 19.4% of patients with rebleeding showed both. The complications such as fever, chest pain, headache, nausea and vomiting, arrhythmia, paralylytic ileus, transient sensory loss(lower extremities), hypotension, urination difficulty were noticed at 40 patients(27.4%). CONCLUSION: We conclude that bronchial artery embolization is relatively safe method achieving immediate control of massive hemoptysis. At initial angiographic findings, we could not find any predictive factors for subsequent rebleeding. It may warrant further study whether patients with pleural disease have definetely increased rebleeding tendency.
Aneurysm ; Arrhythmias, Cardiac ; Arteries ; Bronchial Arteries* ; Chest Pain ; Fever ; Gelatin Sponge, Absorbable ; Headache ; Hemoptysis* ; Hemorrhage ; Humans ; Hypotension ; Ileus ; Mortality ; Nausea ; Pleural Diseases ; Recurrence ; Tuberculosis, Pulmonary ; Urination ; Vomiting