Angiogenesis is a fundamental biological process including endothelial cell adhesion, migration, invasion and tube formation. Integrin receptors of endothelial cells play important roles in angiogenesis. They mediate cell-cell contact and cell adhesion to extracellular matrix. Roles of integrins have been described for a number of cell types. ECV304 endothelial cells were known to overexpress alpha3beta1 integrin and to form tube like structure in 3-D Matrigel culture. However the function of alpha3beta1 integrin in endothelial cells remains to be determined. Therefore, we have investigated morphological characteristics of ECV304 cells and roles of alpha3beta1 integrin in angiogenesis. To elucidate several characteristics, ECV304 endothelial cells were compared with HUVEC in the aspect of morphology, localization of integrins, angiogenesis pattern. In addition, role of alpha3beta1 integrin were analyzed in the aspect of endothelial cell binding, migration, invasion and tube formation on Matrigel. The result showed that alpha3beta1 integrin overexpressed ECV304 endothelial cells showed strong adhesiveness to extracellular matrix proteins, and high migration and invasion activities. Furthermore, expression of alpha3beta1 integrin was increased according to time course during in vitro culture and was continuously strong in ECV304 cells on 3-D Matrigel culture. These results indicate that alpha3beta1 integrin is able to be a critical component in control of angiogenesis by regulation of cell adhesion, migration, invasion and tube formation of ECV304 endothelial cells.
Adhesiveness ; Biological Processes ; Cell Adhesion ; Endothelial Cells* ; Extracellular Matrix ; Extracellular Matrix Proteins ; Integrin alpha3beta1* ; Integrins

BACKGROUND/AIMS: Small-caliber esophagogastroduodenoscopy (scEGD) was developed to facilitate unsedated EGD, and has many advantages over sedated EGD in terms of costs and complications. This study compared the feasibility and tolerance of scEGD with unsedated conventional EGD (cEGD), and examined the effect of the endoscopic diameter on the patients' tolerance. METHODS: A total of 114 patients who were referred for a diagnostic EGD was randomly allocated to undergo either scEGD (GIF XP260, Olympus, diameter 6.5 mm; n=57) or cEGD (GIF XQ240, Olympus, diameter 9.0 mm; n=57). After EGD, the patients and endoscopists completed questionnaires on the level of discomfort, satisfaction and acceptance of the examination. RESULTS: Patients in the scEGD group reported significantly less discomfort (choking, pain and nausea) and more overall satisfaction than those in the cEGD group. Patients in the scEGD group were more willing to choose the same procedure again if medically indicated. According to multivariate analysis, the ultrathin endoscopic diameter itself was positively associated with the increased patients' satisfaction (odds ratio 3.07, p=0.003). CONCLUSIONS: scEGD has comparable feasibility and accuracy but is more tolerable than cEGD. scEGD may have a role in clinical practice by minimizing the level of discomfort during unsedated EGD.
Endoscopy, Digestive System ; Humans ; Multivariate Analysis

BACKGROUND/AIMS: Hypothyroidism is a common side effect induced by sunitinib. Studies have suggested that sunitinib induces destructive thyroiditis or inhibits iodine uptake by the thyroid or anti-thyroid peroxidase activity. Therefore, the amount of iodine intake will also influence the incidence and clinical characteristics of hypothyroidism after sunitinib treatment. We evaluated the incidence and clinical characteristics of hypothyroidism after sunitinib treatment in Korea, an area where iodine is abundant. METHODS: Between November 2005 and July 2007, 25 patients who had thyroid hormone levels measured during or after sunitinib treatment were included. Of the 25 patients, 13 had thyroid function tests (TFT) because they had symptoms suggesting hypothyroidism and 12 underwent TFT independent of symptoms for screening. RESULTS: All 13 patients who had symptoms suggesting hypothyroidism were hypothyroid (9 overt, 4 subclinical), 6 of 12 patients who had TFT independent of symptoms were hypothyroid (2 overt, 4 subclinical), and two had thyrotoxicosis. Of the 19 hypothyroid patients, the 11 overt hypothyroid patients took longer for a diagnosis of TSH elevation (44.5 vs. 14.8 weeks, p<0.05) and had a greater cumulative sunitinib dose (8050+/-3211 vs. 3718+/-1961 mg, p<0.05) compared with the subclinically hypothyroid patients. At the point of detecting TSH elevation, the TSH level correlated with the period and cumulative dose of sunitinib. CONCLUSIONS: The anticipated incidence of sunitinib-induced hypothyroidism is more than 50%. Compared with previous studies performed in other areas, the iodine intake did not affect the incidence of sunitinib-induced hypothyroidism.
Humans ; Hypothyroidism ; Incidence ; Indoles ; Iodine ; Korea ; Peroxidase ; Pyrroles ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis ; Thyrotoxicosis

BACKGROUND/AIMS: Gastric pathology and Helicobacter pylori (H. pylori) infection among Asian patients with Crohn's disease (CD) are still unclear. We evaluated gastric histologic features and frequency of H. pylori infection in Korean patients with CD. METHODS: Among 492 patients with CD receiving upper gastrointestinal (GI) endoscopic evaluation in 19 Korean hospitals, we evaluated the endoscopic findings and gastric histopathologic features of 47 patients for our study. Histopathologic classification was performed using gastric biopsy tissues, and H. pylori infection was determined using the rapid urease test and histology. RESULTS: There were 36 men (76.6%), and the median age of patients at the time of upper GI endoscopy was 23.8 years (range, 14.2-60.5). For CD phenotype, ileocolonic disease was observed in 38 patients (80.9%), and non-stricturing, non-penetrating disease in 31 patients (66.0%). Twenty-eight patients (59.6%) complained of upper GI symptoms. Erosive gastritis was the most common gross gastric feature (66.0%). Histopathologically, H. pylori-negative chronic active gastritis (38.3%) was the most frequent finding. H. pylori testing was positive in 11 patients (23.4%), and gastric noncaseating granulomata were detected in 4 patients (8.5%). Gastric noncaseating granuloma showed a statistically significant association with perianal abscess/fistula (P=0.0496). CONCLUSIONS: H. pylori-negative chronic active gastritis appears to be frequent among Korean patients with CD. The frequency of H. pylori infection was comparable with previous studies. An association with perianal complications suggests a prognostic value for gastric noncaseating granuloma in patients with CD.
Asian Continental Ancestry Group ; Biopsy ; Classification ; Crohn Disease* ; Endoscopy ; Gastritis ; Granuloma ; Helicobacter pylori ; Humans ; Korea* ; Male ; Pathology ; Phenotype ; Stomach ; Urease

PURPOSE: Infliximab is currently used for the treatment of active Crohn's disease (CD). We aimed to assess the efficacy and safety of infliximab therapy and to determine the predictors of response in Korean patients with CD. MATERIALS AND METHODS: A total of 317 patients who received at least one infliximab infusion for active luminal CD (n=198) and fistulizing CD (n=86) or both (n=33) were reviewed retrospectively in 29 Korean referral centers. Clinical outcomes of induction and maintenance therapy with infliximab, predictors of response, and adverse events were evaluated. RESULTS: In patients with luminal CD, the rates of clinical response and remission at week 14 were 89.2% and 60.0%, respectively. Male gender and isolated colonic disease were associated with higher remission rates at week 14. In week-14 responders, the probabilities of sustained response and remission were 96.2% and 93.3% at week 30 and 88.0% and 77.0% at week 54, respectively. In patients with fistulizing CD, clinical response and remission were observed in 85.0% and 56.2% of patients, respectively, at week 14. In week-14 responders, the probabilities of sustained response and remission were 94.0% and 97.1%, respectively, at both week 30 and week 54. Thirty-nine patients (12.3%) experienced adverse events related to infliximab. Serious adverse events developed in 19 (6.0%) patients including seven cases of active pulmonary tuberculosis. CONCLUSION: Infliximab induction and maintenance therapy are effective and well tolerable in Korean patients with luminal and fistulizing CD. However, clinicians must be aware of the risk of rare yet critical adverse events.
Colonic Diseases ; Crohn Disease* ; Humans ; Infliximab* ; Male ; Phenobarbital ; Referral and Consultation ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary