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*

Combined resection of the spleen during total gastrectomy for gastric cancer is usually performed to remove the lymph nodes adequately and thereby achieving surgical radicality. However there is still controversy whether a total gastrectomy combined with a splenectomy can improve the survival rate. The authors retrospectively analyzed 557 gastric cancer patients, who underwent total gastrectomy at the Department of Surgery of Yonsei University during the 7-year period between 1987 and 1993, in order to investigate the influence of combined resection of the spleen upon the patients' survival. The patients were followed until March 1996, and the rate of follow up was 90.6%. The number of cases in which the spleen was saved was 101(the spleen conservation group, SC) and the number of cases in which the spleen was resected was 431(the spleen resection group, SR). Twenty-five cases were excluded due to incomplete data. Among the 431 cases for whom splenectomy was done, 343 were cases in which spleen was the only organ removed other than the stomach (SOR). For the other 88 cases, at least 1 more organs were resected along with the stomach and the spleen(Sp combined). There were no significant differences in the clinical characteristics such as age, sex ratio, tumor size, depth of invasion, nodal stage, TNM stage and histological type between SC and SOR group. In terms of the nodes removed during operation, there was significant difference between the SC and the SOR groups. Also, the Sp combined group showed significant differences in terms of tumor size, depth, nodal stage, TNM stage, and removed nodes. The overall 5-yr survival rate for the spleen conservation group(SC, N=101) was 61.2% and the survival rates according to TNM stage were 94.0% for stage I, 94.1% for stage II, 30.0% for III, and 0.0% for stage IV. The overall 5-yr survival rate for the 343 patients with splenectomy(SOR) was 51.9%, and the survival rates according to TNM stages were 88.7% for stage I, 57.0% for II, 44.0% for III, and 10.8% for stage IV. The overall 5-yr survival rate for the 431 patients with splenectomies or with splenectomies and multiple organ resection(SR) was 48.2%, and the survival rates according to the stages were 88.2% for stage I, 60.2% for II, 41.5% for III, and 6.8% for stage IV. The overall 5-yr survival rate was higher in SC group than in the SOR or the SR groups, but there was no statistical significance to this difference (p>0.05). In a compared according to the TNM stage, the SC group showed better survival rates in the relatively early stages (I, II) than the SOR or the SR groups did; in advanced stages (III, IV), the SOR and the SR groups showed better survival rates than the SC group. However, there was no statistically significant differences in survival among the three groups. These results suggest that during a total gastrectomy, it may be better to save the spleen in early stages of gastric cancer and that it may be better to resect the spleen for adquate lymphadenectomy in grossly advanced stages. To identify statistical difference in survival, it might be necessary to perform a randomized prospective study.
Follow-Up Studies ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Retrospective Studies ; Sex Ratio ; Spleen* ; Splenectomy ; Stomach ; Stomach Neoplasms* ; Survival Rate

The diagnostic accuracy of the data reported in the Korean tuberculosis surveillance system (KTBS) has not been adequately investigated. We reviewed the clinical data of pulmonary tuberculosis (PTB) cases notified from private medical facilities through KTBS between January and June, 2004. PTB cases were classified into definite (culture-proven), probable (based on smear, polymerase chain reaction, histology, bronchoscopic finding, computed tomography, or both chest radiograph and symptoms) or possible (based only on chest radiograph) tuberculosis. Of the 1126 PTB cases, sputum AFB smear and culture were requested in 79% and 51% of the cases, respectively. Positive results of sputum smear and culture were obtained in 43% and 29% of all the patients, respectively. A total of 73.2% of the notified PTB cases could be classified as definite or probable and 81.7% as definite, probable, or possible. However, where infection was not confirmed bacteriologically or histologically, only 60.1% of the patients were definite, probable, or possible cases. More than 70% of PTB notified from private sectors in Korea can be regarded as real TB. The results may also suggest the possibility of over-estimation of TB burden in the use of the notification-based TB data.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis/isolation & purification ; Private Sector ; Republic of Korea/epidemiology ; Severity of Illness Index ; Sputum/microbiology ; Tuberculosis, Pulmonary/*diagnosis/epidemiology/pathology ; Young Adult

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

A retrospective study of 2,603 patients with gastric cancer who underwent a gastric resection at Yonsei University Hospital from 1987 to 1994 was performed to evaluate the clinicopathological characteristics and survival rates of patients with gastric cancer. There were 1721 males and 882 females (ratio=2:1) with a mean age of 54 years (range=22~85 years). All patients underwent gastric resection with curative intent, but 199 patients (7.6%) had a palliative resection. The types of operations were a subtotal gastrectomy in 1,917 patients (73.6%) and a total gastrectomy in 686 patients (26.4%). A D2 or a more extended lymph-node dissection was performed in 2530 patients (97.2%), and only 73 patients (2.8%) had less extensive surgery. The postoperative mortality was 0.9%. The mean diameter of a tumor was 5.6 cm. The most common location of a tumor was the lower third of the stomach (49.4%). Borrmann type III (64.7%) was the most common gross type. The major histologic type was a tubular adenocarcinoma (76.3%). The overall 5-year survival rate was 66.5%. The 5-year survival rates according to the stage were 94.3% in IA, 90.5% in IB, 76.6% in II, 60.1% in IIIA, 38.7% in IIIB, and 12.9% in IV. In the univariate analysis, poor survival was closely related to increasing age, tumor location in the upper one third, larger tumor size, Borrmann type IV tumors, increasing pT and pN classifications, an advanced tumor stage, and perforance of a total gastrectomy. The multivariate analysis revealed that distant metastasis, lymph-node metastasis, depth of invasion, gross type, age, and type of resection were significant prognostic factors. In conclusion, the prognosis for gastric cancer after a gastrectomy has remarkably improved, and the most significant prognostic factors were distant metastasis, lymph node metastasis, and depth of invasion. Therefore, early diagnosis of gastric cancer and aggressive multimodal therapy, especially in patients with stage IIIB and IV tumors might improve the quality of life and the survival of the patients with gastric cancer.
Adenocarcinoma ; Classification ; Early Diagnosis ; Female ; Gastrectomy* ; Humans ; Lymph Nodes ; Male ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Quality of Life ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate*

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*

BACKGROUND: Cyclin-dependent kinase (CDK) inhibitors are family of molecules that regulate the cell cycle. The CDKN2, a CDK4 inhibitor, also called p16, has been implicated in human tumorigenesis. The CDKN2 inhibits the cyclin/CDK complexes which regulate the transition from G1 to S phase of cell cycle. There is a previous report that homozygous deletion of CDKN2 region on chromosome 9p21 was detected frequently in astrocytoma, glioma and osteosarcoma, less frequently in lung cancer, leukemia and ovarian cancer, but not detected in colon cancer and neuroblastoma. However, little is known about the relationship between CDKN2 and laryngeal cancer. Therefore this study was initiated to investigate the role of CDKN2 in human laryngeal squamous cell carcinoma development. MATERIALS AND METHODS: We used 5 human laryngeal carcinoma cell lines whether they have deletions or losses of CDKN2 gene expression by DNA-PCR or RT-PCR, respectively. We examined 8 fresh frozen human laryngeal cancer tissues to detect the loss of heterozygosity (LOH) of CDKN2. PCR was performed by using microsatellite markers of short arm of human chromosome 9 (D9S126, D9S144, D9S156, D9S161, D9S162, D9S166, D9S171, D9S200 and D9SIFNA). For informative cases, allelic loss was scored if the signal of one allele was significantly decreased in tumor DNA when compared to the same allele in normal DNA. RESULTS: The CDKN2 DNA deletion was observed in 3 cell lines. The CDKN2 mRNA expression was observed in only one cell line, which was very weak. LOH was detected in 7 cases (87.5%). CONCLUSION: These results suggest that CDKN2 plays a role in the carcinogenesis of human laryngeal squamous cell carcinoma.
Alleles ; Arm ; Astrocytoma ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Cell Cycle* ; Cell Line* ; Chromosomes, Human ; Colonic Neoplasms ; DNA ; Genes, p16* ; Glioma ; Head* ; Humans ; Laryngeal Neoplasms ; Leukemia ; Loss of Heterozygosity ; Lung Neoplasms ; Microsatellite Repeats ; Neck* ; Neuroblastoma ; Osteosarcoma ; Ovarian Neoplasms ; Phosphotransferases ; Polymerase Chain Reaction ; RNA, Messenger ; S Phase