PURPOSE: To search for evidence of B cell activation and superantigen involvement in Kawasaki disease. METHODS: Peripheral lymphocytes were first isolated from Kawasaki disease patients in the acute and subacute phases. The T cell and B cell distributions were analyzed, cDNA was generated from the total RNA extracts, and PCR amplification of the cDNA for each immunoglobulin heavy chain family was performed to determine the presence of VH family-specific oligoclonal expansion. CDR3 size analysis was then conducted by two-stage PCR. RESULTS: The percentage of B cells increased significantly(P<0.05) in both the acute and subacute phases. Random utilization of diverse VH family genes was observed in the acute phase, and no family-specific expansion was detected. In 13 out of 15 Kawasaki disease patients, an increase in B cells expressing the VH3 family was seen during the acute phase, making it the most frequently utilized family. Analysis of B cell clonal expansion showed the VH6 family clone of 9 amino acids to be the most common clone, observed in 5 out of 15 Kawasaki disease patients. Analysis of the CDR3 size profile in two patients showed that in the acute phase various prominent bands appeared, some disappearing in the subacute phase, while other newly developed bands appeared. CONCLUSION: VH family-specific B cell expansion was not detected, and clonal expansion of B cells was observed, suggesting that Kawasaki disease may be caused by a conventional antigen, and the antigenic stimulation seen during the acute phase seems to be continuous, resuming after clinical resolution.
Amino Acids ; B-Lymphocytes ; Clone Cells ; DNA, Complementary ; Humans ; Immunoglobulin Heavy Chains ; Lymphocytes ; Mucocutaneous Lymph Node Syndrome* ; Polymerase Chain Reaction ; RNA

The vascular lesions in FK506 nephrotoxicity are similar to cyclosporine A, in which mediators related to vascular constriction and thickening such as endothelin, TGF-beta and PDGF may have some roles. Their expressions may be different in terms of degree and time sequence as well as overlapping ischemia, which made us to perform this experiment. Male Sprague Dawley rats received FK506 daily at a dosage of 2 mg/kg by intramuscular route for 4 weeks at maximum and were sacrificed 3 days, 1, 2 and 4 weeks after the initiation of the study, respectively. The control rats received saline. Renal ischemia was induced by occluding the left renal artery for 45 minutes and rats were sacrificed up to 2 weeks after reperfusion. Kidneys were processed for light microscopy and stained with PAS method and with antibodies against endothelin, TGF-beta and PDGF. The number of juxtaglomerular apparatus(JGA) and arterioles positive for each antibody was counted under light microscope and was expressed as mean +/- S.D per mm2 cortex. In FK506 treated rats, JGA and afferent arterioles were prominent with PAS positive granules, which was extended proximally to interlobular arteries with increased duration of FK506 treatment. With increasing duration, TGF-beta reactivity was increased in afferent arterioles. However, no such results were shown in cases of PDGF and endothelin. Renal ischemia itself increased vascular TGF-beta as well as endothelin and PDGF reactivities. Renal ischemia in FK506 treated rats further upregulated the expression of these markers in a similar distribution. However, the expression of endothelin was mostly found in endothelial cells of peritubular and glomerular capillaries. PAS staining was decreased in ischemic kidneys regardless of FK506 treatment. These results indicate that FK506 toxicity was comparable to CsA toxicity. Since expression levels of endothelin, TGF-beta and PDGF were increased in ischemic kidney, it might be helpful to prevent ischemic damage as well as to hinder secretion of these factors in order to reduce FK506 nephrotoxicity.
Animals ; Antibodies ; Arteries ; Arterioles ; Capillaries ; Constriction ; Cyclosporine ; Endothelial Cells ; Endothelins* ; Humans ; Ischemia ; Kidney ; Male ; Microscopy ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Reperfusion ; Tacrolimus* ; Transforming Growth Factor beta*

Trichoblastoma is a rare benign neoplasm that arises in the follicular germinative cells. The terminology and histopathological definition of this tumor is both complex and confusing. Trichoblastoma occurs only on the hair bearing areas such as the scalp, face and pelvic area with varying degrees in size. We describe a case of trichoblastoma occurring as a nodule on the nose. The tumor was composed of numerous lobules of basaloid epithelial cell nests with distinct peripheral palisading of nucleoli that were clearly demarcated from the stroma.
Epithelial Cells ; Hair ; Nose ; Scalp

PURPOSE: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. MATERIALS AND METHODS: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. RESULTS: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. CONCLUSION: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymphedema ; Pelvis ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Treatment Outcome ; Vulvar Neoplasms

PURPOSE: The purpose of this study is to evaluate the differences of the clinicopathological features and survival rates in gastric cancer according to the sex of the patients. MATERIALS AND METHODS: We reviewed 5,784 cases of gastric cancer patients who underwent laparotomy at the Department of Surgery, Seoul National University Hospital fmm Jan. 1986 to Dec. 1995. We have analyzed clinicopathologic features including tumor location, Bonmann type, depth of invasicm, lymph node metastasis, distant metastasis, TNM stage, histologic differentiation and survival rates according to the sex of the patients. RESULTS: The mean age of female patients was 52.4 years, which is lower than that of male, 54.8 years. There were no differences in tumor location, Borrmann type, depth of invasion, lymph node metastasis, distant metastasis, TNM stage of tumor between male and female. But there were some differences in histologic differentiation; well- and moderately differentiated cancers were more common in male and signet-ring cell cancers were more common in female. Female shows slightly better prognosis than male. But the prognosis of young female was poorer than that of young male. CONCLUSION: In gastric cancer patients, differences in histologic differentiation and more aggressive nature of the signet-ring cell cancer in female may affect the survival differences according to the sex.
Female* ; Humans ; Laparotomy ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prognosis ; Seoul ; Stomach Neoplasms* ; Survival Rate

OBJECTIVES AND METHODS: The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. RESULTS: Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinorna: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer..patients was 32.y %(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+GEM>22%) in lung cancer patients was 42.9% (15/35), but none in benign diseases. In (iffy-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. CONCLUSIONS: The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.
Aneuploidy ; Biopsy ; Cell Cycle ; Diagnosis ; Diploidy ; DNA* ; Flow Cytometry ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Neoplasms, Squamous Cell ; Ploidies* ; Surgical Instruments ; Thoracotomy

Renal allografts frequently suffer from ischemia/reperfusion injury, which is a major cause of delayed graft function in renal transplantation(Tx). Cyclosporine(CsA) is known to aggravate ischemic injury, which may further heighten graft dysfunction. To know the histopathologic features of renal ischemic/reperfusion injury and cyclosporoine nephrotoxicity, we performed renal Tx between Lewis rats with cold ischemia and with/without CsA. Rats were sacrificed 3, 5, 7 days, 2, 3 and 4 weeks post-Tx. Control rats received sham operation. The kidney was processed for light microscopy and stained with H-E, PAS. Furthermore, to know the distribution of thioredoxin peroxidase(TPx), a recently cloned antioxidant in this model, the kidney tissue was stained with antibodies against three subtypes of TPx; NKEF-A /PAG(TPx A), NKEF-B/TPx(TPx B) and Mer 5. Renal isografts showed acute tubular necrosis from 3 days and recovery by 7 days, which was prolonged in CsA treated rats with signs of tubular and vascular toxicity. In sham operated rats, TPx A was distributed in all tubular segments, most prominently in distal tubules(DT). TPx B was stained in DT and collecting ducts(CD) exclusively. Mer 5 was present mainly in S3 segment. Glomerular or vascular expression was not found. In isografts TPx A expression was increased in both proximal(PT) and DT, markedly in the nonnecrotic S1 segment till 1 week postTx and returned to normal pattern by 2 weeks. TPx B and Mer 5 expression were increased till 5 days postTx with stronger staining in DT than in PT. CsA sustained the tubular expression of TPx till 4 weeks postTx. In summary, TPx expression was increased in renal tubules of rat renal isografts suffering cold ischemia, and more prolonged with CsA therapy. Marked increase of TPx A expression in S1 segment of ischemic kidneys may indicate resistance against oxidant injury, especially in S1 segment.
Allografts ; Animals ; Antibodies ; Clone Cells ; Cold Ischemia ; Cyclosporine* ; Delayed Graft Function ; Isografts* ; Kidney ; Kidney Transplantation ; Microscopy ; Necrosis ; Peroxiredoxins ; Pilot Projects* ; Rats* ; Reactive Oxygen Species ; Thioredoxins ; Transplants

Rapamycin, a macrocyclic lactone, is effective in reducing the incidence of acute rejection after renal transplantation. The inhibitory effects of rapamycin on lymphocyte proliferation and the molecular mechanisms that were involved have been described. However, its effects on glomerular mesangial cells have not been clearly understood, and here, we examined the effect of rapamycin on platelet-derived growth factor (PDGF) - induced extracellular matrix synthesis as well as cell proliferation in mesangial cells. Rat mesangial cells were isolated from the glomeruli of Sprague-Dawley rats and cultured with Dulbecco's modified Eagles medium containing 20% fetal bovine serum. Different concentrations of rapamycin were administered 1 hour before the addition of 10 ng/ml of PDGF into growth arrested and synchronized cells. Cell proliferation was assessed by [3H]thymidine incorporation, total collagen synthesis by [3H]proline incorporation, and fibronectin secretion into the medium by Western blot analysis. In the mesangial cells, PDGF increased cell proliferation by 4.6-fold, total collagen synthesis by 1.8-fold, and fibronectin secretion by 3.2-fold. Rapamycin above 10 nM significantly inhibited PDGF-induced proliferation and collagen synthesis, but the treatment of rapamycin up to 1micrometer did not show any significant effects on PDGF-induced fibronectin secretion. These inhibitory effects of rapamycin on PDGF-induced mesangial cell proliferation and collagen synthesis reflect the potential value of rapamycin in the prevention and treatment of glomerulosclerosis in patients with chronic allograft nephropathy.
Animals ; Cells, Cultured ; Collagen/*antagonists & inhibitors/biosynthesis ; Fibronectins/*biosynthesis ; Glomerular Mesangium/cytology/drug effects/*metabolism ; Immunosuppressive Agents/*pharmacology ; Male ; Platelet-Derived Growth Factor/*pharmacology ; Rats ; Rats, Sprague-Dawley ; Research Support, Non-U.S. Gov't ; Sirolimus/*pharmacology

PURPOSE: To define the anatomy of apical pleural tenting commonly seen in computed tomography(CT) of the upper posterior thorax. MATERIALS & METHODS: Chest CTs of 393 patients with no pleural disease clinically and radiographically were analyzed. GE-9800 Quick and Toshiba-900S were used, employing the usual contrast enhanced CTtechnique. CT findings of focal pleural tenting on the inner side of the upper posterior thorax(apical pleural tenting) were evalvated and analysed in terms of location and shape. The CT findings were compared with the gross findings of the inner aspect of the posterior cadaveric thorax. RESULTS: Apical pleural tenting was formed by the upper border of the subcostal muscle. It's incidence was 44%(n=171), with bilaterality in 29%(n=49), and unilaterality in 71% of cases(n=122). This tenting was most frequently found between the third rib and the fourth intercostal space(81%), and seen in the outer third(42%) or central third(41%) part of the posterior costalpleura. In fifteen cases(7%), it was directed obliquely and had changed its location from the inner to the centralor the central to the outer part. The shapes of the tenting were classified as follows : type 1(convex innerborder with sharp apex, 62%) ; type 2(convex inner border with broad apex, 23%) ; type 3(undulated contour ofapex, 13%) ; and type 4(two-spike apices, 1%). CONCLUSION: Apical pleura tenting is a normal CT finding probably demonstrated by the upper border of the subcostal muscle. Misdiagnosis of pleural disease can be avoided by recognition of the location and type of this tenting.
Cadaver ; Diagnostic Errors ; Humans ; Incidence ; Pleura ; Pleural Diseases ; Ribs ; Thorax ; Tomography, X-Ray Computed

No abstract available.
Brain* ; Glucose* ; Metabolism* ; Vomiting*