Over-expression of nicotinamide adenine dinucleotide phosphate oxidase (Nox) isoform enzymes was recently reported in various cancers including Burkitt’s lymphoma (BL). However, the functions of Nox isoform enzymes in BL remain poorly understood. In this study, Nox isoform expression and the effects of a Nox-specific inhibitor were evaluated in Epstein-Barr virus (EBV)-positive Raji BL cells in comparison with EBV-negative Ramos BL cells. To evaluate Nox enzyme expression in Raji and Ramos BL cells, polymerase chain reaction (PCR) and western blot analysis were performed. To verify the intracellular signaling mechanism of the Nox inhibitor-induced apoptosis of Raji cells, WST-1 assay, trypan blue exclusion method, flow cytometry, PCR, western blotting, and bromodeoxyuridine staining were conducted. Experiments using the pan-caspase inhibitor z-VAD, reactive oxygen species scavenger N-acetyl-L-cysteine (NAC), and Bim inhibitor 1 were performed. PCR and western blot results showed that Nox isoform enzymes were highly expressed in EBV-positive BL Raji cells compared with EBV-negative BL Ramos cells. The Nox2 inhibitor induced apoptosis of Raji cells in time- and dosedependent manners. The Nox2 inhibitor also caused up-regulation of Bim and Noxa, down-regulation of Mcl-1, translocation of Bax, release of cytochrome c, and caspase cascade activation, resulting in apoptosis. Furthermore, z-VAD, NAC, and BI-1 effectively blocked the Nox2 inhibitor-induced apoptosis of Raji cells. Taken together, these results provide a novel insight into the mechanism of Nox inhibitor-induced apoptosis and evidence for Nox as a therapeutic target to treat EBV-positive malignancies.

Malignant fibrous histiocytoma (MFH) occurs primarily in the extremities and trunk, however primary malignant fibrous histiocytoma of the alimentary tract, particularly of the jejunum, is uncommon. This case report presents a case of malignant fibrous histiocytoma as the primary lesion of the jejunum in a 42-year-old male patient with a 10-day history of melena. A small bowel tumor was resected without complication. The final diagnosis was based on the pathological report of the surgical specimen.
Adult ; Diagnosis ; Extremities ; Histiocytoma, Malignant Fibrous* ; Humans ; Jejunum* ; Male ; Melena

The vectorcardiography was performed on 34 cases with PRWP of precordial leads. We have studied the vectorcardiographic finding for the differential diagnosis of disease entities were obtrained; 1) Poor R-Wave progression of precordial leads has simply considered as suggestion of anterior myocardial infarction, ischemic heart disease, chronic lung disease and normal variant. 2) The sensitivity and specificity of myocardial infarction criteria were 85.8% and 63.0% respectively in left sagittal plane and 85.8% and 66.7% respectively in horizontal plane. 3) The seneitively and specificity of more than 90 QRS-T vector angle in left sagittal plane were 100.0% and 62.5% respectively in ischemic heart disease and myocardial infarction. 4) The sensitively and specificity of chronic lung disease criteria were 85.7% and 51.9% respectively. 5) Vectorcardiographic study was considered as effective differentiating method for patients with PRWP in EKG.
Diagnosis, Differential* ; Electrocardiography* ; Humans ; Lung Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Sensitivity and Specificity ; Vectorcardiography*

Fourteen healthy persons and 43 hypertensives were subjected to treadmill exercise testing to see responses of variable influenced by various degrees of hypertension. The hypertensive were subclassified into 3 groups, mild hypertension(diast. BP<104mmHg), moderate hypertension(diast. BP<129mmHg). 1) The attainability of maximal heart rate was inversely related with levels of basal blood pressure;92.8% of normal control group attained the maximal heart rate, 87.5% of mild hypertension, 69.2% of moderate hypertension and 66.7% of moderately severe hypertension. 2) As the exercise was geaded up, the rate of increase of heart rate was lower in higher blood perssure groups than in lower blood pressuer groups. 3) The rate and extent of rise in systolic pressure was inversely related with basal systolic pressure, the systolic pressure response being least in the group with highest pressure, that is, moderately severe hypertension group. The diastolic pressure seemed to decrease somewhat in early phase of exercise only to return back to basal level at the late phase of exercise. 4) Seven of 43 hypertensive showed significant ST depression during exercise, which may be due to imbalance between oxygen demand and supply caused sither by left ventricular hypertrophy or ischemic heart disease. 5) A case was characterized by very sluggish response in increase of heart rate despite progress in exercise grade and he fell into collase 12 minutes after the interruption of exercise. The tardy response in heart rate may be a hitherto unsuspected risk predictor in exercise test.
Blood Pressure ; Depression ; Exercise Test* ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Myocardial Ischemia ; Oxygen

Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.
Adolescent ; Antibodies, Antinuclear ; Arthritis ; Autistic Disorder ; Epilepsy ; Exanthema ; Female ; Fever ; Humans ; Liver ; Liver Function Tests ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphatic Diseases ; Pharyngitis ; Prednisolone ; Rheumatoid Factor ; Spleen ; Still's Disease, Adult-Onset

PURPOSE: We reviewed 604 cases of varicose veins managed in our hospital and the clinical feature and the results were analyzed between injection sclerotherapy and operative method. METHODS: Retrospective review of clinical records was done from January 1990 to June 1998. All of them were diagnosed as primary varicose veins of lower extremities. Sclerosing agents used were ethanolamine oleate, most commonly, hypertonic saline, sodium tetradecyl sulfate and sclerodex. Injections of the sclerosants were 1 to 5 times as the clinical courses. Then, elastic stocking was applied for 2 weeks. Operations were done under the spinal or general anesthesia and postoperatively remnant varicoses were managed by injection sclerotherapy. Student t-test was used in statistics. RESULTS: The distribution of age were 5th decade (36.8%), 6th decade (24.0%), 4th decade (22.2%) in order of frequency, and the mean age was 44.3 year and the male to female ratio was 1:4.0. The mean duration of illness was 12.6 year, and it was longer in female than male (13.2 vs. 8.7, p=0.02). The most common presumed predisposing factor was longstanding occupation (82% of all) and pregnancy was the 2nd in female (12.0%). Chief complaint was only cosmetic problem in 73% of patients and the others complained varicose induced symptoms and complications. Both lower extremities were involved in 41.9% and right leg was in 26.0%, left leg was in 32.1%. The locations of lesions were calf (41.4%), greater saphenous vein (34.6%), lesser saphenous vein (15.0%). Sclerotherapy was done in 48.0%, operation with sclerotherapy in 23.7%, operation only in 17.2%. The mean duration of illness in sclerotherapy group was significantly shorter than operation group (8.8 vs 14.7 year, p=0.0001). Operation methods were stab avulsion only (48.1%), greater saphenous vein stripping (37.3%) and perforator ligation (11.8%) and others. CONCLUSIONS: Injection sclerotherapy method is very effective and sufficient treatment modality in the management of lower extremity varicose vein with low recurrence and complication rate, especially in the early treated cases.
Anesthesia, General ; Causality ; Ethanolamine ; Female ; Humans ; Leg ; Ligation ; Lower Extremity ; Male ; Occupations ; Oleic Acid ; Pregnancy ; Recurrence ; Retrospective Studies ; Saphenous Vein ; Sclerosing Solutions ; Sclerotherapy ; Sodium Tetradecyl Sulfate ; Stockings, Compression ; Varicose Veins*

PURPOSE: It is increasingly being recognized that the lymph node ratio (LNR) is an important prognostic factor for gallbladder carcinoma patients. The present study evaluated predictors of tumor recurrence and survival in a large, mono-institutional cohort of patients who underwent surgical resection for gallbladder carcinoma, focusing specifically on the prognostic value of lymph node (LN) status and of LNR in stage IIIB patients. METHODS: Between 2004 and 2011, 123 patients who underwent R0 radical resection for gallbladder carcinoma at the Chonnam National University Hwasun Hospital were reviewed retrospectively. Patients were staged according to the American Joint Committee on Cancer 7th edition, and prognostic factors affecting disease free survival, such as age, sex, comorbidity, body mass index, presence of preoperative symptoms, perioperative blood transfusion, postoperative complications, LN dissection, tumor size, differentiation, lymph-vascular invasion, perineural invasion, T stage, presence of LN involvement, N stage, numbers of positive LNs, LNR and implementation of adjuvant chemotherapy, were statistically analyzed. RESULTS: LN status was an important prognostic factor in patients undergoing curative resection for gallbladder carcinoma. The total number of LNs examined was implicated with prognosis, especially in N0 patients. LNR was a powerful predictor of disease free survival even after controlling for competing risk factors, in curative resected gallbladder cancer patients, and especially in stage IIIB patients. CONCLUSION: LNR is confirmed as an independent prognostic factor in curative resected gallbladder cancer patients, especially in stage IIIB gallbladder carcinoma.
Blood Transfusion ; Body Mass Index ; Chemotherapy, Adjuvant ; Cohort Studies ; Comorbidity ; Disease-Free Survival ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Joints ; Lymph Nodes ; Postoperative Complications ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors

OBJECTIVE: The Leksell Gamma Knife(R) (LGK) is based on a single-fraction high dose treatment strategy. Therefore, independent verification of the Leksell GammaPlan(R) (LGP) is important for ensuring patient safety and minimizing the risk of treatment errors. Although several verification techniques have been previously developed and reported, no method has ever been tested statistically on multiple LGK target treatments. The purpose of this study was to perform and to evaluate the accuracy of a verification method (modified variable ellipsoid modeling technique, MVEMT) for multiple target treatments. METHODS: A total of 500 locations in 10 consecutive patients with multiple brain tumor targets were included in this study. We compared the data from an LGP planning system and MVEMT in terms of dose at random points, maximal dose points, and target volumes. All data was analyzed by t-test and the Bland-Altman plot, which are statistical methods used to compare two different measurement techniques. RESULTS: No statistical difference in dose at the 500 random points was observed between LGP and MVEMT. Differences in maximal dose ranged from -2.4% to 6.1%. An average distance of 1.6 mm between the maximal dose points was observed when comparing the two methods. CONCLUSION: Statistical analyses demonstrated that MVEMT was in excellent agreement with LGP when planning for radiosurgery involving multiple target treatments. MVEMT is a useful, independent tool for planning multiple target treatment that provides statistically identical data to that produced by LGP. Findings from the present study indicate that MVEMT can be used as a reference dose verification system for multiple tumors.
Brain ; Brain Neoplasms ; Humans ; Patient Safety ; Radiosurgery

Herein, we present a case of coexisting neuroendocrine carcinoma and conventional adenocarcinoma (collision tumor) in the ampulla of Vater, which has seldom been reported in the literature. A 51-year-old man presented with a month history of jaundice. MRCP disclosed about 1.9x1.8 cm sized heterogeneously enhancing mass in ampulla of Vater, causing obstructions of distal common bile duct. He underwent pylorus-preserving pancreaticoduodenectomy under the diagnosis on ampulla of Vater cancer. Pathologically, sections on the ampulla of Vater showed conventional ductal adenocarcinoma extended and collided with poorly differentiated neuroendocrine carcinoma. In conclusion, we hereby presented a case of coexisting neuroendocrine carcinoma and conventional adenocarcinoma in the ampulla of Vater.
Adenocarcinoma* ; Ampulla of Vater* ; Carcinoma, Neuroendocrine* ; Common Bile Duct ; Diagnosis ; Humans ; Jaundice ; Middle Aged ; Pancreaticoduodenectomy

OBJECTIVE: Maternal anemia is one of the most common hematologic disorders of the child-bearingmothers. However the role of maternal anemia in the etiology of preterm delivery and adverse pregnancyoutcomes remains a source of controversy. The aim of this study was to determine the effects of maternalanemia on the preterm birth and the adverse pregnancy outcomes. STUDY DESIGN: A total of 1,010 women aged 19~44 years, who admitted to our hospitalfor the delivery between December 1994 and October 1995, were recruited into a hospitalbaed case-control study design. 259 women complicated by maternal anemia(cases) werecompared with 751 women without maternal anemia(controls). Multiple logistic regressionanalyses were performed to control for the effects of other potentially confounding factors,including maternal age, body mass index, previous term delivery, previous preterm deliveryand previous abortion. In all logistic regression analyses odds ratio and 95% confidenceintervals were calculated. RESULTS: The prevalence of maternal anemia(hemoglobin<10g/dl) was 25.6%. Therewas a positive linear relationship between the prepartum hemoglobin concentration and thepostpartum concentration. There was no significant differences of the incidence of pretermbirth and the neonatal morbidity, such as poor Apgar scores, fetal distress, congenitalanomaly, birth trauma, admission to neonatal intensive care unit, resuscitation and sepsisbetween case and control groups. Small for gestational age and low birth weight were associatedwith an somewhat decreased risk of maternal anemia and large for gestational age, notmacrosomia, was associated with an 70% increased risk of maternal anemia at the time ofdelivery. Maternal anemia was associated with 6.5 fold increases in the risks of postpartumbleeding, 8.5 fold increases in the postpartum transfusion and 80% increases in the puerperalfever respectively. CONCLUSIONS: Maternal anemia was not associated with increased risks of preterm birthand the neonatal morbidty. However there was a significant relationship between maternalanemia and postpartum maternal morbidity, such as postpartum bleeding, postpartum transfusionand puerperal fever.
Abortion, Induced ; Anemia* ; Body Mass Index ; Case-Control Studies* ; Female ; Fetal Distress ; Fever ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Logistic Models ; Maternal Age ; Odds Ratio ; Parturition ; Postpartum Period ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth* ; Prevalence ; Resuscitation