OBJECTIVETo evaluate the trabecular bone micro-structure from different sites of spine in adolescent idiopathic scoliosis patients. The target site consisted of the bilateral facet joints from apical vertebrae and from end vertebrae.

METHODSNine AIS patients with mean age 14.9 years (range 12-17 years) and mean Cobb angle 56 degrees (ranged 48 degrees-84 degrees) were recruited into this study. Corrective surgery was indicated to these patients, and facet joint biopsies were collected during decortications for spinal fusion. Biopsy consents were obtained from patients. Bone specimens were fixed with routine histology procedures and scanned by micro computer tomography (muCT40, Scanco Medical, Switzerland). Ten pairs of facet joint were harvested from apical vertebrae and 12 pairs from end vertebrae. Three-dimensional reconstructed images with the resolution of 20 microm were achieved for histomorphometric analysis.

RESULTSThe values of BV/TV (0.268 vs. 0.354, P < 0.05), TbTh (0.20 vs. 0.24, P < 0.05), TbSP (0.66 vs. 0.56, P < 0.05) and BS/BV (12.7 vs. 10.4, P < 0.05) between convex and concave side at the apex area were significantly different. No difference was found in any structural parameters between left and right side at end area, and upper thoracic (T5, 6) and thoracolumbar (T12, L1).

CONCLUSIONDue to asymmetric compression and tension shared between convex and concave side, more bone and thicker and more profound trabecular bones are observed in the concave side than in the convex side, which seems to resist the progression of spinal curvature. This finding suggests that the provocative factors which cause the progression of the curve in certain patients may not lie in the bone component of spine.

Adolescent ; Child ; Female ; Humans ; Scoliosis ; diagnostic imaging ; pathology ; physiopathology ; Tomography, X-Ray Computed ; Zygapophyseal Joint ; pathology ; physiopathology

The present study was done to validate the two-site Semmes-Weinstein (SW) monofilament test in identifying patients at risk of lower-extremity complications in clinical setting. The SW monofilament test and nerve conduction study were conducted on type 2 diabetic patients (n=37) at Pusan National University Hospital in Korea. As the duration of diabetes mellitus was longer, neuropathy identified by nerve conduction study and complications of diabetes were more severe (p<0.01). The number of sites unable to perceive SW monofilament (p<0.001) was larger in patients with lower-extremity neuropathy symptoms than those without symptoms. Sensitivity and specificity at two sites (the third and fifth metatarsal head sites) were 93% and 100%, respectively. In conclusion, the two-site SW monofilament test was a sensitive, specific, simple, and inexpensive screening tool for identifying diabetic peripheral neuropathy in clinical setting.
Aged ; Comparative Study ; Diabetes Mellitus, Type II/complications* ; Diabetic Neuropathies/diagnosis* ; Female ; Human ; Male ; Middle Aged ; Neural Conduction ; Neurologic Examination/instrumentation* ; Neurologic Examination/methods ; Pressure ; Sensation Disorders/diagnosis* ; Sensation Disorders/etiology ; Sensitivity and Specificity ; Touch

PURPOSE: Of the cancers in childhood, leukemia is the most frequent one. For the desirable control of childhood leukemia, the basic data for the incidence has a great importance. The authors made a report about the incidence of leukemia in childhood, which analyzed the data from 126 cases in Kyongnam province, Korea, during 1991~1995. METHODS: The data were obtained from 126 new cases of childhood leukemia who had been living in the Kyongnam province and were diagnosed at the 26 university hospitals or general hospitals in the Kyongnam area and other cities from 1991 to 1995. RESULTS: The age-and-sex adjusted annual incidence rate per 100,000 population during 1991~1995 varied from 1.82 to 2.86, and cumulative annual incidence rate was 2.41 (male 2.26 and female 2.57 respectively). Male to female sex ratio was 1:1 in total cases. By the major types of childhood leukemia, the cases were composed of acute lymphocytic leukemia 70.6%, acute myelocytic leukemia 26.9% and chronic myelocytic leukemia 2.5%. The cumulative annual incidence rate per 100,000 population (crude rate) during 1991~1995 were 2.77 in Ulsan city, 2.62 in Chinju city and 2.34 in the whole area of Kyongnam province. CONCLUSION: It was concluded that the age-and-sex adjusted annual incidence rate per 100,000 of childhood in Kyongnam province was 2.41, which was lower than that in Pusan city in the same period. And, there was no significant difference of the cumulative annual incidence rate between Ulsan area and Chinju area in the same period.
Busan ; Female ; Gyeongsangnam-do* ; Hospitals, General ; Hospitals, University ; Humans ; Incidence* ; Korea* ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sex Ratio ; Ulsan

BACKGROUND: The classical treatment of the cervical cancer is surgery, radiotherapy, chemotherapy. Even though the improvement of treatment successful rate, conventional therapy has some limitations. Recent cutting edge of cancer therapy has been developed in gene level including understand the biological characteristics of the cancer cells, enhance the human immune response, suppress the cancer cell proliferation. Therefore, the gene therapy is proposed to new treatment strategy. PURPOSE: The transfection efficiency of cervical cancer cell lines and cervical cancer cell line xerografted nude mouse was investigated by transfection of liposome and infection of adenovirus mediated suppressor(p53) and reportor(LacZ) gene. METHOD: The cervical cancer cell lines was used in this study were CaSki, SiHa (HPV16 positive, wild type p53 gene), HeLa, HelaS3(HPV18 positive, wild type p53 gene) and C33A, HT3(HPV negative, mutant p53). Direct plasmide and AdCMVp53 gene transfection was performed by using liposome system (pRcCMVLacZ / lipofectin, FuGene 6, Ca-phosphate). LacZ gene was used as the reportor gene for the transfection efficiency evaluation. Expression of p53 in cell lines and tumor tissue was confirmed by western blot and immunohistochemical staining. Xenografted nude mouse of SiHa cell line was infected by AdCMVp53 and AdCMVLacZ. Transfection efficiency was observed by same as above. RESULTS: In cervical cancer cell lines, gene transfection using liposome system(pRcCMVLacZ/lipofectin, FuGene 6, Ca-phosphate)revealed different transfection efficiency, especially pRcCMVLacZ in Fugene 6 showed 18-40% of high transfection efficiency in 6 cervical cancer cell lines by X-gal staining and AdCMVp53 showed 95-98% of the high transfection efficiency in HeLa, C33A. AdCMVp53 was significantly expressed at 2-5days after injection xenografted nude mouse on the western blot and transfection efficiency was 19.79+/-5.36, 26.26+/-11.69, 14.77+/-3.98,15.99+/-6.43%(day1-5). AdCMVLacZ were found to immuno- histochemistry analysis, in vivo transfection efficiency was 61.26+/-4.66,59.63+/-9.12, 29.46+/-14.33, 31.73+/- 22.64%(day 1-5) atx200 and 88.65+/-8.65, 70.85+/-20.94, 40.75+/-25.44, 48.21+/-10.97% (day 1-5) atx400. CONCLUSION: As a results, adenovirus-mediated transfection efficiency was higher in vivo experiment compared to cell lines. These high efficiency of adenovirus-mediated suppressor gene(p53) could become a significant meaningful data gene therapy strategy both transgenic mice and cervical cancer cell lines.
Adenoviridae* ; Animals ; Blotting, Western ; Cell Line* ; Cell Proliferation ; Drug Therapy ; Genes, p53* ; Genetic Therapy ; Heterografts* ; Humans* ; Lac Operon ; Liposomes ; Mice ; Mice, Nude* ; Mice, Transgenic ; Plasmids ; Population Characteristics ; Radiotherapy ; Transfection* ; Uterine Cervical Neoplasms*

Hypnic headache is a unique headache disorder that occurs exclusively during sleep and often with "alarm-clock" consistency. It is a rare, benign, moderately severe, enduring headache syndrome that occurs in middle-aged to elderly adults and affects both sexes. The pathophysiology of hypnic headache is unknown, but its circardian periodicity and responsiveness to lithium suggest chronobiologic sleep disturbance contributing to the genesis of hypnic headache. We have recently experienced 2 cases of hypnic headache. They showed the characteristic signs of hypnic headache. We present our cases and discuss the pathophysiology of hypnic headache.
Adult ; Aged ; Headache Disorders ; Headache Disorders, Primary* ; Humans ; Lithium ; Periodicity

De novo B-cell prolymphocytic leukemia (B-PLL) is a distinct clinicopathologic entity that was first described in 1974 by Galton et al. B-PLL is characterized by marked lymphocytosis with predominance of prolymphocytes, often massive splenomegaly, minimal lymphadenopathy, often aggressive clinical course and frequently poor prognosis.We experienced a case of B-PLL associated with false-positive direct antiglobulin test. The patient was 52 year-old man who presented with marked leukocytosis (160.2x103/(mu)L) and 60% of characteristic prolymphocytes in the peripheral blood. The bone marrow aspirate showed dry tap and the PAS stain of peripheral blood smear showed positivity of prolymphocytes. The immunophenotyping of the leukemic prolymphocytes revealed the positivity of surface immunoglobulin (IgM, lambda type), HLA-DR, CD19 and CD5.
Bone Marrow ; Coombs Test* ; HLA-DR Antigens ; Humans ; Immunoglobulins ; Immunophenotyping ; Leukemia ; Leukemia, Prolymphocytic* ; Leukemia, Prolymphocytic, B-Cell ; Leukocytosis ; Lymphatic Diseases ; Lymphocytosis ; Middle Aged ; Splenomegaly

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of [18F]FDG PET in the diagnosis of recurrent head and neck cancer after the completion of surgery and radiotherapy in patients with head and neck cancers. MATERIALS AND METHODS: In fifty-nine patients with head and neck cancers, whole body [18F]FDG PET studies were performed. According to the different therapeutic modalities, patients were divided into four groups (Group I; pre-treatment, Group II; surgery, Group III; radiotherapy, Group IV; both surgery and radiotherapy). [18F]FDG PET images were compared with clinical, CT and histopathologic findings. RESULTS: For detection of metastatic lymph nodes in 14 patients of pre-treatment group (group I), the sensitivity and specificity of PET were 100% (10/10) and 75% (3/4), and those of CT were 80% (8/10) and 100% (4/4). For detection of recurrence in 45 patients of post-treatment group, overall sensitivity and specificity of PET were 96.2% (25/26) and 78.9% (15/19) [(100% and 75% in group II, 80% and 50% in group III, and 100% and 100% in group IV)] without significant difference from pre-treatment group (p>0.1). In detecting recurrence, the sensitivity and specificity of [18F]FDG PET were 90.9% (10/11) and 20% (1/5) in 16 patients who underwent [18F]FDG PET within 2 months after the completion of treatment. The specificity of these patients was significantly lower than that of 29 patients (100% of sensitivity and specificity) who underwent [18F]FDG PET 2 months after treatment (p<0.05). CONCLUSION: [18F]FDG PET is an accurate diagnostic modality for the detection of recurrence in head and neck cancer. Post-therapy [18F]FDG PET should be obtained at least 2 months after the completion of surgery or radiotherapy.
Diagnosis ; Head and Neck Neoplasms ; Head* ; Humans ; Lymph Nodes ; Neck* ; Radiotherapy* ; Recurrence ; Sensitivity and Specificity

PURPOSE: Adverse reactions to mosquito bites have been recognized for some time, and these usually consist of large swellings, generalized urticaria, angioedema, and less frequently asthma. There have been some efforts to define immunologic characteristics of mosquito allergens throughout the world. But, in Korea, the immunologic analysis of mosquito allergen have not been made. METHODS: Extracts of locally distributed female mosquito Culex pipiens, were prepared from their heads and thoraxes. By sodium dodecylsulfate-polyacrylamide gel electrophoresis, proteins of two extracts were isolated. Then their proein bands were transferred to nitrocellulose membrane. Immunoblotting was performed with sera of allergic patients to mosquito bites, then completed by antibodies to human IgE. RESULTS: Immunoblotting showed IgE binding proteins weighing 70 kD, 60 kD, 34 kD in Culex pipiens. CONCLUSION: We found that mosquito antigens induced IgE response, and it suggested that species-specific antigens exist. Further investigation using salivary gland extracts from Culex genus are needed in identifying specific allergens.
Allergens* ; Angioedema ; Antibodies ; Asthma ; Collodion ; Culex* ; Culicidae* ; Electrophoresis ; Female ; Galectin 3 ; Head ; Humans ; Immunoblotting ; Immunoglobulin E ; Korea ; Membranes ; Salivary Glands ; Sodium ; Thorax ; Urticaria

PURPOSE: Cockroaches have been reported one of the major causes of allergic disease such as bronchial asthma and allergic rhinitis. About 10% of children and 20% of adult respiratory allergy patients have positive results of allergy skin tests to cockroach allergen. This finding suggests that cockroach is also important allergen in Korea. Among 4,000 species, German cockroach seems predominant species in the Korean peninsula. Identification and charactrerization of the major allergen is the first step in German cockroach allergen research. But, there have been controversies. It may depends upon different identifying methods. The aim of our study was to identify the major allergen in German cockroach using Westernblot. METHODS: Crude German cockroach allergen extracts with or without protease inhibitor cocktail mixture were prepared, and protein patterns of these two extracts were compared using SDS-PAGE and Coommssie stain. Sera from 32 atopic asthmatic patients with positive allergy skin test against cockroach allergen were used for IgE immunoblot. RESULTS: Coomassie stain after SDS-PAGE demonstrated some discordance between the differently prepared crude allergen extracts. In comparison with the allergen extract which abolished endogenous protease activity, the untreated extract revealed new 32, 55 and 78 kD protein bands and 41 kD protein band was disappeared. About 60% of sera with positive allergy skin test revealed IgE binding bands in Westernblot. Among them, 10, 21, 25, 36 and 52 kD protein band might seemed important German cockroach allergen. CONCLUSION: Finding above may suggest that endogenous protease could denature allergenic proteins in the process of crude cockroach allergen extract. The 10, 21, 25, 36, and 52 kD might be the important allergens in German cockroach.
Adult ; Allergens ; Asthma ; Blattellidae* ; Child ; Cockroaches ; Electrophoresis, Polyacrylamide Gel ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea ; Protease Inhibitors ; Rhinitis ; Skin Tests

Autoimmune neutropenia is characterized by severe neutropenia with cell-bound neutrophil antibodies or circulating antibodies for neutrophils. Diagnosis of disease is made of the basis of the presence of antibodies for neutrophil. Corticosteroid or rhG-CSF have been reported to be effective in some patients. Recently we experienced one case of autoimmune neutropenia patient who was admitted to our hospital in 1997 because of stomach cancer and degenerative joint disease. She had severe neutropenia without underlying autoimmune disease. And cell-bound neutrophil antibodies were detected by indirect immunofluorescence test. Treatments with rhG-CSF and steroid result in transient improvement of neutropenia and subtotal gastrectomy was done successfully. We herein report one case of autoimmune neutro- penia patient, to our best knowledge, the first report in Korea, with a brief review of literature.
Antibodies ; Autoimmune Diseases ; Diagnosis ; Fluorescent Antibody Technique, Indirect ; Gastrectomy ; Humans ; Joint Diseases ; Korea ; Neutropenia* ; Neutrophils ; Stomach Neoplasms