BACKGOUND: Transforming growth factor-beta (TGF-alpha) has been implicated in the pathogenesis of a number of kidney diseases. However, TGF-alpha is secreted in a latent form requiring extracellular modification to become biologically active. Recently, the activity of TGF-alpha has been assessed by the measurement betaig-h3, a novel TGF-alpha induced gene product. Thus we evaluated the pattern of urinary betaig-h3 expression in various glomerular diseases. METHODS: 64 patients with biopsy-proven primary glomerulonephritis (FSGS 6, HSPN 16, IgAN 20, MPGN I 7, and MesPGN 15), 10 patients with nephrotic syndrome and 12 healthy controls were enrolled in the study. A total 86 subjects (51 males, 59.3% and 35 females, 40.7%, mean age 13.9+/-4.28 years) constituted study population. First morning urine were collected and betaig-h3 in the urine was determined by indirect competitive ELISA (Regen Biotech Inc, Seoul, Korea). RESULTS: betaig-h3 excretion was significantly higher in the urine from patients with HSPN (27.5+/-6.46, p=0.002), with IgAN (40.83+/-12.27, p=0.026), with MPGN I (21.64+/-7.29, p=0.042), MesPGN (26.42+/-6.68, p=0.007). In patients with FSGS (21.65+/-17.12) and minimal change nephrotic syndrome (6.26+/-2.18), mean urinary betaig-h3 excretion was not significant higher than that in control group (3.56+/-0.78). CONCLUSION: Urinary betaig-h3 excretion was high in proliferative renal diseases. However, betaig-h3 excretion was not high in non-proliferative renal diseases.
Enzyme-Linked Immunosorbent Assay ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney Diseases ; Male ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Seoul ; Transforming Growth Factor alpha

PURPOSE: The purpose of this study was to evaluate the differences according to the hospitals of antenatal care in premature infants. METHODS: We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and very low birth weights who were admitted immediately after birth to the neonatal intensive care unit (NICU) at the Dongguk University Ilsan Hospital between March 2007 and February 2009. The hospitals of antenatal care were divided into two levels (primary antenatal care hospital: hospitals with less than a level 2 NICU, secondary antenatal care hospital: hospitals with a level 3 NICU) based on the level of NICU in hospitals. In addition, total infants were divided into two groups (Immediate group: infants born within 24 hours of maternal admission, Delayed group: infants born after 24 hours of maternal admission). The differences between maternal and neonatal variables in each groups were studied. RESULTS: Neonates in secondary antenatal care hospitals comprised 11.0% of the study neonates (10 of 91). We compared with two groups (primary antenatal care hospital and secondary antenatal care hospital), but there were no differences in all subjects. However, the 1 minute Apgar score (< or =3) was lower in the immediate group than the delayed group. CONCLUSION: Shorter duration of maternal admission to delivery was associated with a lower 1 minute Apgar score of neonates. These findings suggest that if maintenance of pregnancy is difficult when high-risk gravidas are transferred, clinicians must prepare for emergencies of neonates.
Apgar Score ; Emergencies ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Medical Records ; Parturition ; Pregnancy ; Prenatal Care ; Retrospective Studies

BACKGROUND: Anthracofibrosis, a descriptive term for multiple black pigmentation with fibrosis on bronchoscopic examination, has a close relationship with active tuberculosis (TB). However, TB activity is determined in the later stage by the TB culture results in some cases of anthracofibrosis. Therefore, it is necessary to identify early markers of TB activity in anthracofibrosis. There have been several reports investigating the serum levels of IL-2 sRalpha, IFN-gamma and TBGL antibody for the evaluation of TB activity. In the present study, we tried to measure the above mentioned serologic markers for the evaluation of TB activity in patients with anthracofibrosis. METHODS: Anthracofibrosis was defined when there was deep pigmentation (in more than two lobar bronchi) and fibrotic stenosis of the bronchi on bronchoscopic examination. The serum of patients with anthracofibrosis was collected and stored under refrigeration before the start of anti-TB medication. The serum of healthy volunteers (N=16), patients with active TB prior to (N=22), and after (N=13), 6 month-medication was also collected and stored. Serum IL-2 sRalpha and IFN-gamma were measured with ELISA kit (R&D system, USA) and serum TBGL antibody was measured with TBGL EIA kit (Kyowa Inc, Japan). RESULTS: Serum levels of IL-2 sRalpha in healthy volunteers, active TB patients before and after medication, and patients with anthracofibrosis were 640+/-174, 1,611+/-2,423, 953+/-562, and 863+/-401 pg/ml, respectively. The serum IFN-gamma levels were 0, 8.16+/-17.34, 0.70+/-2.53, and 2.33+/-6.67 pg/ml, and TBGL antibody levels were 0.83+/-0.80, 5.91+/-6.71, 6.86+/-6.85, and 3.22+/-2.59 U/ml, respectively. The serum level of TBGL antibody was lower than that of other groups (p<0.05). There was no significant difference of serum IL-2 sRalpha and IFN-gamma levels among the four groups. CONCLUSION: The serum levels of IL-2 sRalpha, IFN-gamma and TBGL antibody were not useful in the evaluation of TB activity in patients with anthracofibrosis. More useful ways need to be developed for the differentiation of active TB in patients with anthracofibrosis.
Bronchi ; Constriction, Pathologic ; Enzyme-Linked Immunosorbent Assay ; Fibrosis ; Healthy Volunteers ; Humans ; Interleukin-2* ; Pigmentation ; Refrigeration ; Tuberculosis* ; Tuberculosis, Pulmonary

Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis.
Abdomen/diagnostic imaging ; Aged ; Alcoholism/pathology ; Chronic Disease ; Diagnosis, Differential ; Focal Nodular Hyperplasia/*diagnosis ; Humans ; Imaging, Three-Dimensional ; Liver/diagnostic imaging/*pathology ; Liver Diseases/pathology ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Ultrasonography

Epidemiologic studies were conducted on 31 cases of Salmonella group E infection detected in 2000 through a laboratory-based pathogen surveillance in Gangwon Province, Korea. Data were collected on the environmental exposures and the patients' foods, including the brand (s) of milk consumed before the onset of diarrhea. The patients' medical records were also reviewed. All of the patients were infants under 10 months of age except one 7-year old child. Surprisingly, all of the infants were fed with infant formulas from Company A, although two infants were fed with infant formulas from both Company A and Company B. Antimicrobial susceptibility test and pulsed-field gel electrophoresis (PFGE) were performed in 25 out of 31 isolates from the patients and in 1 isolate from an opened packet of infant formula collected from the home of an infected infant. All of the 26 isolates were Salmonella enterica serovar London. They showed a single PFGE pattern, and all of the isolates were susceptible to the 18 antibiotics tested. The causative agent of the salmonella outbreaks in the Gangwon Province and its surrounding areas was Salmonella London, and the highly likely source of the infection was infant formula from Company A.
Child ; DNA, Bacterial/analysis ; *Disease Outbreaks ; Female ; *Food Contamination ; Human ; Infant ; *Infant Formula ; Infant, Newborn ; Korea/epidemiology ; Male ; Salmonella Infections/*epidemiology/*transmission ; Salmonella enterica/classification/genetics/*isolation & purification

BACKGROUND: For securing FTSG, bolus tie-over dressing is a universally accepted method, but it has some definite disadvantages. For example, bulky dressing inhibits the drainage from graft bed and can lead to maceration by occlusion. Time and effort is necessary to secure dressing and the help of an assistant is also mandatory to tie the suture much easier. OBJECTIVES: In an attempt to find a better dressing material, we evaluated the usefulness of thermoplastic nasal splints (Aquaplast(R)) for securing graft in FTSG reconstruction. METHODS: Thirteen patients with surgical defects following tumor excision from the nose(9 patients), forehead(1), lip(1), hand(1), shin(1) ranging from 12mm to 40mm in the largest diameter were reconstructed with a FTSG. For securing FTSG, a heat-moldable nasal splint was heated, contoured in place over sutured graft on recipient area with/without suture of the splint with skin. RESULTS: All of the 13 FTSG secured with nasal splints showed a good take with a satisfactory cosmetic results. Except hypertrophic scars in 4 patients, which were not significant and improved with several times intralesional injection of triamcinolone, there were no other complications. CONCLUSION: We have found a heat-moldable nasal splint to be useful material to secure FTSG, especially for the complex contoured area such as nose or ear. This technique saves time and effort and there is no need of an assistant.
Bandages ; Cicatrix, Hypertrophic ; Drainage ; Ear ; Hot Temperature ; Humans ; Injections, Intralesional ; Nose ; Skin* ; Splints* ; Sutures ; Transplants* ; Triamcinolone

Acute mesenteric venous thrombosis (MVT) is an uncommon form of intestinal ischemia with high mortality and usually occurs in the setting of preexisting comorbidities including thrombophilia and abdominal inflammatory conditions. Hyperhomocysteinemia has been known to be a risk factor for thromboembolism, often located on an unusual site. Considering that homocysteine metabolism is determined genetically to a high degree, a mutant of methylenetetrahydrofolate reductase (MTHFR) C677T causes hyperhomocysteinemia, leading to thrombophilia. Until now, there have been few reports of MVT associated with MTHFR gene mutation. We, herein, report a case of small bowel infarction associated with MVT by MTHFR gene mutation in an adult without any other risk factors of thrombophilia.
Adult ; Comorbidity ; Homocysteine ; Humans ; Hyperhomocysteinemia ; Infarction* ; Ischemia ; Mesenteric Veins ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Mortality ; Risk Factors ; Thromboembolism ; Thrombophilia ; Thrombosis ; Venous Thrombosis*

Primary leiomyosarcoma rarely occurs in bone; when it occurs, it is more frequent in middle-aged individuals and frequently metastasizes to the lung. Here, we report a case of primary leiomyosarcoma of the femur in a 47-year-old woman who complained of pain in the left hip. The plain x-ray revealed an osteolytic lesion in the greater trochanter of the femur. The histopathological and immunohistochemical evaluation revealed a moderately differentiated leiomyosarcoma. Computed tomography of the chest and abdomen revealed no other potential primary lesions. The patient was diagnosed with primary leiomyosarcoma of the bone. Although surgical removal was recommended, the patient refused surgery. As an alternative, she was given radiotherapy and chemotherapy. No local progression or distant metastasis has been observed during the 4-year follow-up period.
Abdomen ; Drug Therapy ; Female ; Femur* ; Follow-Up Studies ; Hip ; Humans ; Leiomyosarcoma* ; Lung ; Middle Aged ; Neoplasm Metastasis ; Radiotherapy ; Thorax

Background/Aims: Platelet-derived growth factor receptor alpha-positive (PDGFRα + ) cells function in the purinergic regulation of gastrointestinal motility, and purines are reportedly inhibitory neurotransmitters in the enteric nervous system. We explore the distribution and function of PDGFRα + cells related to purinergic inhibitory neurotransmission in human right and left colons. Methods: Human colonic segments were prepared with mucosa and submucosa intact, and the circular muscle tension and longitudinal muscle tension were recorded. Purinergic neurotransmitters were administered after recording the regular contractions.Immunohistochemistry was performed on the circular muscle layers. Intracellular recording was performed on the colonic muscular layer. SK3, P2RY1, and PDGFR-α mRNA expression was tested by quantitative real-time polymerase chain reaction (qPCR). Results: Adenosine triphosphate (ATP) treatment significantly decreased the frequency and area under the curve (AUC) of the segmental contraction in right and left colons. Beta-nicotinamide adenine dinucleotide (β-NAD) decreased the frequency in the right colon and the amplitude, frequency and AUC in the left colon. Apamin significantly increased frequency and AUC in the left colon, and after apamin pretreatment, ATP and β-NAD did not change segmental contractility. Through intracellular recordings, a resting membrane potential decrease occurred after ATP administration; however, the degree of decrease between the right and left colon was not different. PDGFRα +Conclusion Purines reduce right and left colon contractility similarly, and purinergic inhibitory neurotransmission can be regulated by PDGFRα+ cells in the human colon.

BACKGROUND: The therapeutic effects of surfactants on acute lung injury derive not only from their recruiting action on collapsed alveoli but also from their anti-inflammatory action in the alveolar space. This study evaluated the anti-inflammatory action of a surfactant in an acute lung injury model of rats by measuring the WBC count, IL-1beta and IL-6 level of bronchoalveolar lavage(BAL) fluid. In addition, neutrophils were recollected from the BAL fluid and the NF-kappa B activity of the neutrophilic nuclear protein was evaluated. METHODS: Male Sprague-Dawley rats weighing approximately 300 gram were divided into 3 groups, which consisted of 6 rats respectively. In the control group, normal saline(3ml/kg) was instilled into the trachea twice with 30 minute interval. In two other groups, acute lung injury was induced by the intra-tracheal instillation of LPS(5mg/kg). Thirty minutes later, either a surfactant(ST group; 30mg/kg) or normal saline(NT group: 3ml/kg) was instilled via the trachea. Twenty-four hours after the LPS instillation, the BAL fluid was retrieved to measure the WBC count and cytokine(IL-1beta and IL-6) levels. The neutrophils were isolated from the BAL fluid and the nuclear protein was extracted to evaluate the NF-kappa Bactivity using a eletrophoretic mobility shift assay(EMSA). RESULTS: The WBC count of the BAL fluid of the ST group(3,221+/-1,914 X 10(3)/micro liter) was higher than that of the control group(356+/-275X10(3)/micro liter)(p<0.05) and lower than that of the NT group(5,561+/-1,757 X 10(3)/micro liter)(p<0.05)). The BAL fluid level of IL-1beta from the NT group(2,064+/-1,082pg/ml) was higher than those of the ST group(360+/-234pg/ml)(p<0.05) and the control group(0pg/ml)(p<0.05). The BAL fluid concentration of IL-6 from the NT group(3,621+/-567pg/ml) was also higher than those of the ST group(1,754+/-1,340pg/ml)(p<0.05) and control group(49+/-62pg/ml)(p<0.05). The NF-kappa B activity of the neutrophilic nuclear protein in the ST group and NT group was similar. CONCLUSIONS: The surfactant attenuates the alveolar inflammation in the acute lung injury of rats model. However, its anti-inflammatory action does no't appear to be mediated by the inhibition of NF-kappa B activity.
Male ; Humans ; Rats ; Animals