BACKGROUND AND OBJECTIVES: Mucus hypersecretion is a major problem in inflammatory airway disease. Interleukin-1beta (IL-1beta) has been implicated in the pathogenesis of inflammatory airway diseases. This study was designed to investigate the signal transduction mechanism and the relationship between cyclooxygenase-2 (COX-2) expression and the IL-1beta-mediated MUC5AC secretion. MATERIALS AND METHOD: In cultured human airway NCI-H292 epithelial cells, the IL-1beta-mediated MUC5AC gene expression and mucin secretion were analyzed by reverse transcription-polymerase chain reaction and immunoassay. To identify the signal transduction pathway of the IL-1beta-mediated MUC5AC expression, we used specific inhibitors. RESULTS: IL-1beta induced COX-2 and MUC5AC expression at the mRNA and protein levels. Mucin secretion was blocked by NS398 and resveratrol, selective COX-2 inhibitors. Prostaglandin E2 (PGE2) directly induced MUC5AC expression at both mRNA and protein levels in a dose-dependent manner. Cells activated by IL-1beta showed increased extracellular-regulated protein kinase (ERK) 1/2 and p38 phosphorylation. IL-1beta-induced MUC5AC gene expression and mucin secretion were blocked by PD98059, the MEK/ ERK inhibitor and SB203580, the p38 inhibitor. Furthermore, inhibition of both mitogen-activated protein kinases (MAPKs) reduced the IL-1beta-induced COX-2 expression and PGE2 synthesis. Ro31-8220, the PKC inhibitors prevented the IL-1beta-induced COX-2 expression and mucin secretion. Also Ro31-8220 inhibited the IL-1beta-mediated MAPKs phosphorylation. CONCLUSION: IL-1beta-induced MUC5AC gene expression and mucin secretion are regulated through the sequential activation of PKC-ERK/ p38-COX-2-PGE2 in the human airway NCI-H292 epithelial cells.
Cyclooxygenase 2 ; Cyclooxygenase 2 Inhibitors ; Dinoprostone ; Epithelial Cells* ; Gene Expression* ; Humans* ; Immunoassay ; Interleukin-1 ; Interleukin-1beta ; Mitogen-Activated Protein Kinases ; Mucins* ; Mucus ; Phosphorylation ; Prostaglandin-Endoperoxide Synthases ; Protein Kinase C ; Protein Kinases ; RNA, Messenger ; Signal Transduction

OBJECTIVES: The purpose of this study was to investigate the clinical characteristics of "fake bad" and "fake good" patients with traumatic head injury in neuropsychological tests. METHODS: We measured subjective symptoms by SCL-90-R and objective symptoms by McBride obstacle-valuation measure. The patient was divided into three groups according to differences between subjective and objective symptoms. We also examined their intelligence, memory, clinical characteristics, using K-WAIS, K-MAS, MMPI. RESULTS: The group who overly expressed their subjective symptoms has its psychotic symptom exaggeratingly measured, so it will be helpful to be careful to such over-expressed symptoms in those who present a psychotic symptom in a clinical view-point. An K-WAIS measurement among those who exaggerated their subjective symptoms showed less value than the actual one, which weakens the reliability of this intelligent test. Rather, for that group, the result of K-MAS can be used with a confidence in the estimation of their severity of symptoms. CONCLUSION: MMPI and neuropsychological tests are helpful to understand characteristics between subjective symptoms and objective disabilities of patients with traumatic head injury.
Craniocerebral Trauma* ; Head* ; Humans ; Intelligence ; Memory ; MMPI* ; Neuropsychological Tests*

There has been considerable controversy over the prognosis of mucinous gastric enocarcinoma (MGC). In this study we analyzed the clinicopathologic fferences between MGC and non-mucinous gastric carcinoma (NMGC). In addition, e relationship between mucin content and other clinicopathologic variables, cluding prognosis in MGC, was also investigated. We reviewed 2118 patients th pathologically-confirmed gastric cancer who underwent gastrectomy at the partment of Surgery, Yonsei University College of Medicine, during the period tween Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric carcinoma th extracellular mucin (MGC) and 1988 patients had gastric carcinoma without tracellular mucin (NMGC). We placed the MGC patients into two groups according mucin content: mucin content involving over 50% of the tumor (dominant type, = 94) and mucin content involving less than 50% of the tumor area (partial pe, n = 36). The results were as follows: MGC was more common in males than GC. The size of the tumor in MGC (mean 5.3 cm) was larger than that of NMGC ean 4.4 cm). The patients with MGC had a higher incidence of Borrmann type IV GC: 16.1%, NMGC: 9.9%), more frequent serosal invasion (MGC: 75.4%, NMGC: .6%), lymph-node metastasis (MGC: 75.4%, NMGC: 50.7%), and peritoneal tastasis (MGC: 10.0%, NMGC: 3.5%) than patients with NMGC. The patients with C were more advanced in stage at the time of diagnosis and had a worse overall -year survival rate (44.9%) than patients with NMGC (54.7%). However, the -year survival rate according to the stage of MGC was similar to that of NMGC. ere were no significant differences between the mucin content and other thologic variables, including prognosis, i.e. similar biologic behavior tween dominant type MGC and partial type MGC. In conclusion, we suggest that C was more frequently diagnosed in advanced stage than NMGC with a poorer ognosis and that it is reasonable to consider the carcinoma with mucin content volving more than 30% of the tumor area as MGC.
Adenocarcinoma/pathology ; Adenocarcinoma/metabolism ; Adenocarcinoma, Mucinous/pathology* ; Adenocarcinoma, Mucinous/metabolism* ; Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Male ; Middle Age ; Mucins/metabolism ; Neoplasm Staging ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/metabolism*

The purpose of this study was taken after transplantation of fetal serotonin and substance-P containing raphe nuclei into the transected thoracic spinal cord (T9-10) of adult rats, a suspension of cells derived from the mesencephalic and medullary raphe nuclei of 13~15 days embryonic rats were injected upper and lower the transected spinal cord. After survival periods of 15 days to 1 year, the animals were sacrificed and the spinal cord, processed for the localization of serotonin and substance-P immunoreactive neurons in the transplanted spinal cord, was studied using ABC immunocytochemistry. Immunocytochemical analysis revealed the presence of many serotonin and substance-P immunoreactive neurons in the transplants. In the mesencephlic implants, however, the serotonin and substance-P immunoreactive neurons were not co-localized with the same neurons. The serotonin and substance-P nerve fibers were densely distributed in lamina I and II of the dorsal horn and in lamina VIII and IX of the ventral horn of all segments of the spinal cord. The nontransplanted control, spinal cord of the rats showed a total absence of serotonin and substance-P immunoreactive fibers below the section. Immunoelctronmicroscopic anlysis demonstrated the presence of numerous synaptic contacts formed by serotonin and substance-P containing boutons which are most likely emanated from the grafted serotonin and substance-P.
Adult ; Animals ; Axons* ; Horns ; Humans ; Immunohistochemistry ; Nerve Fibers ; Nerve Tissue* ; Neurons ; Raphe Nuclei ; Rats* ; Serotonin* ; Spinal Cord* ; Transplants

BACKGROUND: Head and neck cancer is curable at early stages with local-regional therapy. However, most patients are diagnosed with advanced stage disease that requires combination therapy. The aim of this study was to determine the efficacy of docetaxel and cisplatin combination chemotherapy, in patients with advanced head and neck cancer by evaluating the response, survival and organ preservation rates. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 39 patients with advanced head and neck cancer who received docetaxel and cisplatin combination chemotherapy from March 2000 to July 2004. RESULTS: The average age of the 39 patients was 53.4 (range 30 to 73 years) years and the most common primary site was the hypopharynx (23.0%). There were 36 patients who had stage IV disease and three patients with stage III disease. The overall response rate was 76.9% (30/39), including 12 complete responses (30.8%) and 18 partial responses (46.1%). The response rate based on the primary cancer and neck metastasis was 74.4% and 69.3%; the differences were not significant. Among 16 patients with laryngeal and hypopharyngeal cancer, 13 (81.2%) had their larynx preserved after chemotherapy followed by radiotherapy and a survival rate of 61.5%; three patients (18.8%) received a total laryngectomy and had a survival rate of 66.7%. The overall survival rate from the start of chemotherapy was 56.4% with a median survival of 30 months. The common toxicities observed were alopecia, vomiting, diarrhea, hepatotoxicity and anemia but they were all generally manageable. CONCLUSION: Docetaxel and cisplatin combination chemotherapy is an effective regimen with a relatively high response rate and acceptable toxicity
Alopecia ; Anemia ; Cisplatin* ; Diarrhea ; Drug Therapy ; Drug Therapy, Combination* ; Head and Neck Neoplasms* ; Head* ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; Laryngectomy ; Larynx ; Medical Records ; Neck ; Neoplasm Metastasis ; Organ Preservation ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Vomiting

BACKGROUND: Head and neck cancer is curable at early stages with local-regional therapy. However, most patients are diagnosed with advanced stage disease that requires combination therapy. The aim of this study was to determine the efficacy of docetaxel and cisplatin combination chemotherapy, in patients with advanced head and neck cancer by evaluating the response, survival and organ preservation rates. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 39 patients with advanced head and neck cancer who received docetaxel and cisplatin combination chemotherapy from March 2000 to July 2004. RESULTS: The average age of the 39 patients was 53.4 (range 30 to 73 years) years and the most common primary site was the hypopharynx (23.0%). There were 36 patients who had stage IV disease and three patients with stage III disease. The overall response rate was 76.9% (30/39), including 12 complete responses (30.8%) and 18 partial responses (46.1%). The response rate based on the primary cancer and neck metastasis was 74.4% and 69.3%; the differences were not significant. Among 16 patients with laryngeal and hypopharyngeal cancer, 13 (81.2%) had their larynx preserved after chemotherapy followed by radiotherapy and a survival rate of 61.5%; three patients (18.8%) received a total laryngectomy and had a survival rate of 66.7%. The overall survival rate from the start of chemotherapy was 56.4% with a median survival of 30 months. The common toxicities observed were alopecia, vomiting, diarrhea, hepatotoxicity and anemia but they were all generally manageable. CONCLUSION: Docetaxel and cisplatin combination chemotherapy is an effective regimen with a relatively high response rate and acceptable toxicity
Alopecia ; Anemia ; Cisplatin* ; Diarrhea ; Drug Therapy ; Drug Therapy, Combination* ; Head and Neck Neoplasms* ; Head* ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; Laryngectomy ; Larynx ; Medical Records ; Neck ; Neoplasm Metastasis ; Organ Preservation ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Vomiting

BACKGROUND: The use of intraoperative brainstem auditory evoked potential (BAEP) has reduced the incidence of sensorineural hearing loss (SNHL) after microvascular decompression (MVD). This complication occurs due to direct compressive and/or stretching injury of the cochlear nerve or to indirect compression of the perineural vasculature during cerebellar retraction. The aim of this study was to evaluate the effect of thiopental sodium on SNHL after MVD for hemifacial spasm. METHODS: 94 hemifacial spasm patients with normal hearing function preoperatively and who underwent MVD under intraoperative BAEP monitoring were enrolled in this study. Patients were randomly divided into two groups. 52 patients were administered placebo (control group) and 42 patients were administered thiopental sodium 5 mg/kg intravenously 5 minutes before cerebellar retraction (thiopental group). The effects of thiopental on intraoperative BAEP changes and postoperative hearing functional outcomes were sought. Incidence and degree of postoperative SNHL were evaluated by pure tone audiometry threshold analysis. RESULTS: Maximal changes in intraoperative BAEP parameters did not differ between the two groups, and neither did the incidence nor degree of SNHL. In the control group, 4 transient and 4 permanent postoperative SNHL, including 2 deaf patients, occurred with an overall incidence of 15.4%. In the thiopental group, 2 transient and 1 permanent postoperative SNHL occurred, with an overall incidence of 7.1%. CONCLUSIONS: Thiopental sodium administered prior to cerebellar retraction might reduce the incidence of postoperative hearing loss.
Audiometry ; Cochlear Nerve ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing* ; Hemifacial Spasm ; Humans ; Incidence ; Microvascular Decompression Surgery* ; Thiopental*

A microdebrider is increasingly used in endoscopic sinus surgery. Although it has many advantages over conventional instruments, it has been associated with severe complications. We treated a case of rupture of the left medial rectus muscle after use of a microdebrider during endoscopic sinus surgery in a 50 year-old female patient who complained of binocular diplopia and exotropia. The patient showed marked limitation on adduction and about 40 prism diopters of left exodeviation. The orbital computed tomography showed a bony defect at the left medial orbital wall, and injury of the medial rectus muscle. The exodeviation was corrected after ophthalmologic surgery. We report a case of the rupture of the medial rectus muscle after use of a microdebrider during endoscopic sinus surgery and review the medical literature.
Diplopia ; Exotropia ; Female ; Humans ; Middle Aged ; Orbit ; Rupture ; Telescopes

The surgical approach to juvenile nasopharyngeal angiofibroma (JNA) is determined by the topographic localization, the extent of the tumor, and the experience of the surgical team.1)2) Current surgical options include lateral rhinotomy, midfacial degloving, transpalatal, infratemporal fossa, and transnasal approaches.2)3) Recently, the transnasal endoscopic surgical approach has sometimes been applied to treat benign tumors such as JNA.1)3)4) Transnasal endoscopic excision of a case of JNA limited to the left posterior nasal cavity, nasopharynx, and anterior pterygopalatine fossa was performed successfully on a 17-year old male patient. An endoscopic follow-up at postoperative two years did not indicate residual tumor or recurrence.
Adolescent ; Angiofibroma* ; Follow-Up Studies ; Humans ; Male ; Nasal Cavity ; Nasopharynx ; Neoplasm, Residual ; Pterygopalatine Fossa ; Recurrence

There has been a considerable controversy on the prognosis of the mucinous gastric adenocarcinoma(MGC). In this study we analyzed the clinicopathologic differences between MGC and non-mucinous gastric carcinoma(NMGC). In addition, the relationship between mucin content and other clinicopathologic variables, including prognosis in MGC was examined. We reviewed 2118 patients with pathologically confirmed gastric cancer who had underwent gastrectomy at the department of surgery of Yonsei University College of Medicine, during the period between Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric cancer with extracellular mucin(MGC) and 1988 patients had gastric carcinoma without extracellular mucin(NMGC). We studied the MGC patients into two groups according to mucin content: mucin content involving over 50% of the tumor(dominant type, n=94) and mucin content involving less than 50% of the tumor area(partial type, n=36). The results are as follows: The MGC was more common in male then NMGC. The size of tumor in MGC was larger than that of NMGC. The patients with MGC had higher incidence of Borrmann type IV, more frequent serosal invasion, lymph nodes metastasis and peritoneal metastasis than the patients with NMGC. The patients with MGC had more advanced stage at the time of diagnosis and worse overall 5-year survival rate than the patients with NMGC. But the 5-year survival rate according to the stage of MGC was similar to that of NMGC. There were no significant differences between the mucin content and other pathologic variables including prognosis. So we suggested that MGC has worse prognosis than NMGC and it is reasonable to consider the carcinoma with mucin content involving less than 50% of the tumor area as MGC.
Adenocarcinoma* ; Diagnosis ; Gastrectomy ; Humans ; Incidence ; Lymph Nodes ; Male ; Mucins* ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms ; Survival Rate