Activated Leukocyte Cell Adhesion Molecule Modulates Th2 Immune Response in Atopic Dermatitis

PURPOSE: Activated leukocyte cell adhesion molecule (ALCAM), a member of the immunoglobulin superfamily, is highly expressed on dendritic cells. ALCAM and its receptor CD6 are co-stimulatory molecules in the immunological synapse; their interaction is required for T cell activation. While atopic dermatitis (AD) is recognized as a T helper 2 (Th2)-mediated allergic disease, the role of ALCAM in its pathogenesis is unclear. METHODS: ALCAM levels were measured in the serum of AD patients and AD-induced murine model by ovalbumin treatment. We next investigated transepidermal water loss, clinical score, Th2-immune responses, skin barrier gene expression and T-cell activation using wild-type (WT) and ALCAM deficiency mice. An oxazolone-induced AD-like model was also established and analyzed using WT- and ALCAM-deficient mice. RESULTS: We found that serum ALCAM levels were elevated in pediatric AD patients as well as WT AD mice, whereas Th2-type cytokine production and AD symptoms were suppressed in ALCAM-deficient mice. In addition, CD4+ effector T-cell counts in murine skin and skin-draining lymph nodes were lower in ALCAM-deficient mice than in their WT counterparts. ALCAM deficiency was also linked to higher expression of skin barrier genes and number of lamellar bodies. CONCLUSIONS: These findings indicate that ALCAM may contribute to AD pathogenesis by meditating a Th2-dominant immune response and disrupting the barrier function of the skin.

Five cases of abdominal sacral colpopexy for the vaginal vault prolapse after total hysterectomy / 대한산부인과학회잡지

A rate com;lication of hysterectomy is complete prolapse and inversion of vagina. This can occur whether the hysterectomy was abdominal or vaginal and cystocele and/or enterocele is often associated with this condition. Traditionally, prolapse has been treated by surgery, the types of operation for prolapse are generally but not always, carried out through the vaginal rather than through the abdominal surgical route. We experienced five cases who had repair of posthysterectomy vaginal vault prolapse by transabdominal sacral colpopexy and report with brief review of literatures.

Traumatic Cerebrospinal Fluid Rhinorrhea: Successful Closure under the Surgical Microscope

The authors report a case of traumatic cerebrospinal fluid rhinorrhea accompanied by psychotic symptoms in which intracranial approach was performed under the surgical microscope for closure of the cerebrospinal fluid fistula, and satisfactory result were obtained.

A Case of Large Dermoid Cyst

The authors describe a case of large dermoid cyst of the scalp which removed surgically and cosmetically. Dermoid cyst is derived from epiblastic cells predestined to form skin which become detached from their neighbours and included in mesenchyme at about third to the fifth week of feral life, when the neural tube is closing. The contents of the cyst are thus mixtures of keratin, sebum, and hair, according to the proportionate development of these elements. It is usually a single tumor and may develop almost anywhere in the subcutaneous tissue, being of variable size.

A Case of Tuberculoma in Cerebral Hemisphere

The authors report a case of tuberculoma of the cerebral hemisphere, which has been excised under the operating microscope. With the references reviewed, this case is interesting one in supratentorial location.

A Case of Tuberculous Epidural Granuloma: Case Report

The authors describe a case of tuberculous epidural granuloma at the level of the 4th thoracic spine in a 27-year-old woman. Extraosseous origin of tuberculous granuloma has been rarely reported. With the references reviewed, the pathogenesis of Pott's paraplegia is discussed.

A Case of Malignant Brain-Stem Glioma : Microsurgical Decompression and Biopsy: Case Report

The authors report a case of malignant brain-stem glioma with typical clinical signs in which successful surgical decompression and biopsy were obtained under the surgical microscope, and factors favoring surgical removal of such lesion are discussed.

Reduction and Fusion in Cervical Fracture Dislocation

With the establishment of the anterior cervical approach as the procedure of choice for cervical fracture-dislocation, attention has now turned to refinements of Cloward technique. The purpose of application of the Cloward technique is to achieve early stabilization of the fracture-dislocation, to shorten the recumbency period, and to promote rehabilitation. Recently the authors have experienced with the Cloward technique in the treatment of cervical fracture-dislocation. Our results indicated that anterior interbody fusion has been a satisfactory method for stabilizing one or more segment of the cervical fracture-dislocation. The prevention of dowel fracture or extrusion following fusion has been a important factor in the success. Another advantage obtained is to use the operating microscope for decompression of nerve roots. The chronic locked facets have not been reduced by the application of Cloward technique, but have been managed to achieve stabilization with Smith-Robinson technique. The lateral cervical pucture technique(C1-C2) for pantopaque myelography has been shown to be a valuable adjunct of acute injuries of the cervical spinal cord. A new technique for wiring and fusion of atlanto-axial dislocation has been performed with satisfactory results.

A Technique of Lateral Cervical Puncture for Pantopaque Myelography: Technical Note

The various special diagnostic procedures have been used for the cervical cord injuries. The author describes a new technique of pantopaque cervical myelography based on the lateral C1-2 puncture.

A Technique of Posterior Fusion for the Atlanto-axial Dislocation with Odontoid Process Fracture: Technical Note

The authors describe a new technique for the reduction and wiring of atlanto-axial dislocation. More strong supporting effect has been achieved by double wiring of the posterior arch of the cervical vertebrae. Various techniques for the fixation of the atlanto-axial dislocation have been discussed.olved.

Experimental Brain Edema(Part III)

The cerebral compression and edema were successfully produced by the expansion of the stalk of laminaria in the right epidural space of the rabbits. By weighting the wet and dry brain tissues, and by calculating the percentage of water content and that of swelling, with the rate of per cent water content to that of control group, the studies of the occurrence and changes of experimental brain edema have been observed. In the normal rabbits, the average per cent water content of cerebral gray and white matters were 79.9+/-0.7% and 73.0+/-1.0% respectively. The percentage of water content and swelling of cerebral gray and white matters in the compression site showed higher values than those in control group. As compared with normal group, the rate of per cent water content of cerebral gray matter at the site of compression showed gradual increasing tendency as time elapsed by 24 hours, while that of white matter demonstrated rapid increased of it by 6 hours and decreased gradually thereafter. And it appeared that the value of the cerebral white matter showed higher than that of gray matter throughout the period of 24 hour's compression. Cereral edema induced by laminaria compression was more evident and severe in the white matter than in the gray, which was more striking at the early stage of cerebral compression.

Experimental Brain Edema(Part IV): Oxygen Consumption of Cerebral Tissues in Experimentally Induced Edema

Numerous experimental and clinical studies of brain metabolism have reported since last two decades and many authors have concentrated their efforts on the metabolism of gas, glucose, electrolytes and enzymes. Oxygen and glucose that are utilized in the brain are two of the most important substances and play very important roles in the brain to form high energy bond(adenosine triphosphate) and nucleic acid. Authors have attempted to measure oxygen consumption in normal rabbit brains and diseased brains that are produced the expansion of stalk of laminaria in the right epidural space of the rabbit. In the normal rabbits, the average value of oxygen consumption of cerebral gray and white matters were 3.44+/-0.29---lO2/100 mg(dry weight)/30 min and 0.72+/-0.04---lO2/100 mg(dry weight)/30 min respectively. The value of oxygen consumption of cerebral gray and white matters in the compressed hemisphere showed high values than those in control group, and they revealed a tendency of rather rapid increase at an early experimental stage, and of gradual decrease thereafter.

Experimental Spinal Cord Compression: Part I, Water Content and Oxygen Consumption

Experimental spinal cord compression was successfully produced in the rabbit by the expansion of the stalks of "laminaria", a sea weed, which was placed in the spinal epidural space at the level of fifth lumbar vertebrae. The experimental spinal cord compression and subsequent edema at the site of compression and its adjacent area were studied at interval of 6, 12 and 24 hour's compression by measuring wet weight and dry weight, and by calculating percent water contents, swelling percent and changesa of water content to that in control group. The oxygen consumption of cord tissues at the site of compression and its distal adjacent area of the spinal cord was investigated by using Warburg's manometric apparatus supplying 100% oxygen. In the normal rabbit, the average water content of the spinal cord was 63.38+/-0.9%. The percentage of water and swelling of the cord tissues in experimental group were higher than those in the control during the period of 24 hour's compression, and that at the site of compression they showed a tendency of rapid increase in value at an early stage, and the area adjacent to the compression demonstrated values increasing gradually during the process of compression. In control group, the average value of oxygen consumption of the cord tissue was 0.48+/-0.01---lO2 mg(dry weight)/30 min. The values of oxygen consumption of cord tissue at the site of compression and distal adjacent area were higher than in control group at an early stage and gradually decreased thereafter. It was noted that the changes of water content and oxygen consumption of spinal cord were well and influenced by the mechanical compression with "laminaria" insertion in the rabbit, resulting in spinal cord edema.

Radiofrequency Coagulation of Percutaneous Dorsal Root Ganglionotomy(Case Report)

Streotaxic electrocoagulation of sensory pathway using radiofrequency currents is now a well established treatment mode for intractable pain control. However bilateral cordotomy, when needed, carry serious respiratory risks or motor deficit. Because of such problems, radiofrequency coagulation of dorsal root ganglia have been extended recently. We treated a case of intractable pain in both legs after spine injury with the radiofrequency dorsal root ganglionotomy. A 36 year-old male was admitted to our department complaining of severe intractable pain in oth legs. On neurological examination he was somewhat emaciated, both legs were paralysed below the knee joint with anesthesia below L4 dermatomes. Marked muscular atrophy on both legs were also observed. Bladder functions were preserved weakly. The patient was placed on the X-ray table in the prone position, 18 gauge spinal needle is directed under the radiographical control into the intervertebral foramen, so that the tip is halfway between inferior border of pedicle and upper border of superior articular process. Proper positioning of needle was tested by electrical stimulation and dorsal root ganglionotomy carried out at L4-5, L5-S1 interspaces using radiofrequency coagulation at 70 mA for 10 sec. And 30 mA for 10 sec. Postoperative results were satisfactoryv.

Clinical Study of Mannitol and Steroid Effect on Head Injured Patients

Although various studies of effectiveness of mannitol and steroid for the brain swelling have been reported, there are still few reports on cerebral trauma. This study is based on electrolyte change after the infusion of hypertonic mannitol and steroid, and basedon evaluation of Prognostic effect followed mannitolization. Author studied 36 operative cases of brain stem dysfunction group, 70 operative cases of semicomatous group of cerebral traumas, who were admitted at Woo Suk Hospital, Korea University Medial College from Jan. 1968 to Sept. 1971. Author measured degree or reduction of C.S.F. pressure continuously under adequate mannitolization and checked electrolytes preoperatively and after mannitolization and C.B.C., Urinalysis, daily Urine out put and Urine S.G. were also checked. The results was summarized as follows. 1) The reduction of C.S.F. pressure started approximately one, one and half hours after mannitolization. 2) Better prognosis was obtained, in preoperative administration of mannitol and steroid infused case. a) loser mortality, b) rapid metal recovery, c) prolonged survival. 3) In electrolyte changes; No remarkable dilutional hyponatremia was seen.