We examined the effect of class II transactivator (CIITA) down-modulation on allograft rejection. To inhibit the function of CIITA, we constructed a series of CIITA mutants and found one exhibiting the dominant-negative effect on the regulation of major histocompatibility complex (MHC) class II expression. To test whether the CIITA dominant-negative mutant reduces immunogenecity, CIITA-transfected melanoma cells were injected into allogeneic host and assessed for immune evading activity against host immune cells. We demonstrated that the CIITA dominant-negative mutant allowed tumor nodules to develop earlier in the lung than control by this tumor challenge study. Furthermore, skin grafts deficient for CIITA also survived longer than wild-type in allogeneic hosts. Both the tumor challenge and skin graft studies suggest the inhibition of CIITA molecules in donor tissue would be beneficial to the control of allo-response.
Transplantation, Homologous ; Transfection ; Trans-Activators/genetics/*immunology/metabolism ; Trans-Activation (Genetics)/genetics/immunology ; Skin Transplantation ; Nuclear Proteins/genetics/*immunology/metabolism ; Mutation ; Mice, Transgenic ; Mice, Knockout ; Mice, Inbred C57BL ; Mice, Inbred BALB C ; Mice ; Melanoma, Experimental/genetics/immunology/pathology ; Male ; Interferon Type II/pharmacology ; Humans ; Histocompatibility Antigens Class II/genetics/*immunology/metabolism ; Graft Survival/genetics/immunology ; Graft Rejection/genetics/*immunology ; Genes, MHC Class II/genetics/immunology ; Flow Cytometry ; DNA, Complementary/genetics ; Cell Proliferation/drug effects ; Cell Line, Tumor ; Animals

PURPOSE: Gallstone disease has been presumed to be a sequellae of gastrectomy. To know correlation between gallbladder disease and gastrectomy, we check anatomical and functional status of gallbladder with ultrasonogram in our study. METHODS: Gallbladder motility after gastrectomy was studied by means of measuring fasting and postprandial gallbladder volume using real time ultrasonography in 50 gastrectomized patients and in 28 controls (healthy but not operated gastric cancer patients) were selected as study subjects. RESULTS: Mean fasting and postprandial gallbladder volume was significantly increased in gastrectomized patient group (FV: 37.63+/-20.70 ml, PV: 11.50+/-10.26 ml) than control group (FV: 22.17+/-10.35 ml, PV: 5.44+/-3.67 ml, p<0.01). The ejection fraction of gallbladder in gastrectomized patient group (69.05+/-14.57%)was significantly smaller than control group (75.57+/-10.26%, p<0.05). CONCLUSION: The risk of gallbladder disease was independent of age, sex, and post-operative duration in our study. Gastrectomy may have the possibility of increasing the risk of gallbladder disease by causing gallbladder dysmotility and bile stasis. So, gallbladder motility evaluation would be helpful for prevention and understanding gallstone formation. Further study will be needed about the clinical benefits of prophylactic cholecystectomy during gastrectomy.
Bile ; Cholecystectomy ; Fasting ; Gallbladder Diseases ; Gallbladder* ; Gallstones* ; Gastrectomy* ; Humans ; Stomach Neoplasms* ; Ultrasonography

PURPOSE: Mediastinal staging of non-small cell lung cancer can be markedly improved by FDG-PET scan, but the problem of false staging of mediastinal nodes by PET scan in non-small cell lung cancer has not yet been overcome. The aim of this study was to identify the mechanism underlying the false staging of mediastinal nodes by FDG-PET in the case of non-small cell lung cancer. MATERIALS AND METHODS: To evaluate the factors determining the FDG uptake in mediastinal nodes, FDG-PET was performed preoperatively, and mediastinal dissection with pulmonary resection was performed in 62 patients with NSCLC. GLUT-1 expression was studied by immunohistochemistry of the mediastinal nodes (n=111, true positive 31, true negative 41, false positive 27, false negative 12) using the anti-GLUT-1 antibody. The size, percentage of tumor (tumor ratio), labeling index (rate of stained tumor), staining intensity of the tumor, level of follicular hyperplasia, and staining intensity of the follicle center in the mediastinal node were also studied. RESULTS: There was no significant difference in size among the 4 nodal groups (TP, TN, FP, FN), nor in the tumor ratio of the metastatic nodes between the TP and FN groups. The labeling index and staining intensity of the TP group were higher than those of the FN group (Mann-Whitney test, p=.001, p=.007) in the case of the metastatic nodes. The level of follicular hyperplasia of the FP group was higher than that of the TN group in the case of the non-metastatic nodes (p=.000). CONCLUSION: These results suggest that in mediastinal staging of non-small cell lung cancer by FDG-PET, the FN node is associated with low uptake of FDG due to low expression of GLUT-1, and that the FP node is associated with a high level of follicular hyperplasia as a result of there being a reactive change to an inflammatory and/or immune reaction. This is the first report on the mechanism underlying the false results that are sometimes obtained, and which constitute a major problem in the clinical application of FDG-PET to the mediastinal staging of non-small cell lung cancer.
Carcinoma, Non-Small-Cell Lung* ; Glucose Transport Proteins, Facilitative ; Humans ; Hyperplasia ; Immunohistochemistry ; Positron-Emission Tomography

Although Nerium indicum poisoning is a globally rare occurrence, Nerium oleander poisoning is known to occur frequently in the Mediterranean regions. To our knowledge, this is the first reported case of accidental Nerium indicum poisoning in Korea. Its poisoning symptoms and signs are similar to that of digitalis poisoning, because of the presence of cardiac glycosides in Nerium indicum. A 16-year-old boy was admitted to the emergency department four hours prior to the accidental ingestion of Nerium indicum petals. The patient complained of nausea, vomiting, and dizziness. His initial vital signs were stable; laboratory blood test results were within normal levels, except for the blood digoxin level (1.5 ng/dL). An electrocardiogram (ECG) analysis showed normal sinus rhythm, progressive PR prolongation and second-degree Morbiz type I AV block. Conservative treatments including activated charcoal administration were conducted, because toxic symptoms and signs were not severe. The patient was admitted to the intensive care unit for close observation. His ECG was converted to normal rhythm after 1 day and the toxic symptoms and signs were completely resolved after 4 days.
Adolescent ; Atrioventricular Block ; Cardiac Glycosides ; Charcoal ; Digitalis ; Digoxin ; Dizziness ; Eating ; Electrocardiography ; Emergencies ; Hematologic Tests ; Humans ; Intensive Care Units ; Korea ; Mediterranean Region ; Nausea ; Nerium ; Vital Signs ; Vomiting

PURPOSE: To investigate the epidemiology and clinical characteristics of centipede bite injuries. METHODS: We conducted a retrospective study of clinical manifestations in patients who were identified between April 2005 to April 2007 as having suffered from centipede bites. Factors evaluated included sex, age, location and time of bite, part of body affected, clinical signs and symptoms, treatment modalities and complications. RESULTS: A total of 179 cases of centipede bite were identified. Centipede bites occurred between spring and autumn. 69.3% of bites happened at night. All patients were bitten on an exposed body parts, and the digit of both the handsand feet were the sites most often involved. Pain, swelling, erythema were the most frequent symptoms and signs. Most cases showed minor manifestations but, three patients needed to be admitted because of anaphylaxis. CONCLUSION: Centipede bites are relatively common in the summer season in rural and island areas, especially at night. Though the clinical symptoms of centipede bites are generally minor symptoms, emergency physicians need to possess accurate knowledge of the clinical manifestations in order to properly identify severe cases.
Anaphylaxis ; Arthropods ; Bites and Stings ; Emergencies ; Erythema ; Foot ; Human Body ; Humans ; Korea ; Retrospective Studies ; Seasons

PURPOSE: Recombinant ScFv lym-1 was produced, using pET vector system for large scale production. METHODS: ScFv lym-1 gene inserted pET-22b (+) vector, was expressed in E.coli BL-21 strain. ScFv lym-1 antibody extracted from periplasm, was purified with His-Taq column. To evaluated immunoreactivity with Raji cell, ScFv lym-1 was labeled with I-125 and I-125 ScFv lym-1 was purified with desalting column. Raji cell was injected into the C57BR/cdJ SCID mice. Gamma camera imaging were taken time point at 1, 8, 24, and 48 hr with 8 mm pinhole collimator. RESULTS: An active scFv lym-1 could be produced in E.coli with soluble from using pET vector system. Immunoreactivity and affinity constant of IgG lym-1 were 54% and 1.83 x 10(9) M(-1), respectively, and those of scFv lym-1 were 53.7% and 1.46 x 10(9) M(-1), respectively. Biodistribution of I-125 scFv lym-1 antibody showed faster clearance in blood, spleen, kidney and than I-125 IgG lym-1 antibody. Gamma camera image of I-125 scFv lym-1 antibody showed faster clearance and tumor targeting liver than I-125 IgG lym-1 antibody. CONCLUSIONS: In vitro properties of scFv lym-1 were similar to those of IgG lym-1. ScFv lym-1 showed faster blood clearance than IgG lym-1. These results suggest that scFv lym-1 antibody can be useful for tumor imaging agent.
Animals ; Gamma Cameras ; Immunoglobulin G ; Kidney ; Liver ; Lymphoma* ; Mice ; Mice, SCID ; Periplasm ; Radionuclide Imaging ; Spleen

Renal venous thrombosis occurs, for the most part, as secondary to nephrotic syndrome. In relation to infection, cases complicated with acute pyelonephritis and renal abscess have been reported. A 71-year-old woman was admitted due to vomiting, abdominal pain, watery diarrhea, and fever. Abdominal computed tomography (CT) revealed diffuse thickening of the small intestinal wall and left renal venous thrombosis. The enteritis rapidly resolved with conservative treatment including fasting and antibiotic therapy; anticoagulation therapy was started. After 3 months, the renal vein thrombosis had much improved, but a tiny remnant thrombus was seen on follow-up abdominal CT. After 4 months of additional anticoagulation therapy, the remnant thrombus remained unchanged, at which point warfarin was switched to clopidogrel, an antiplatelet agent, and after 8 months the remnant thrombus was no longer visible on abdominal CT.
Abdominal Pain ; Abscess ; Aged ; Diarrhea ; Enteritis* ; Fasting ; Female ; Fever ; Follow-Up Studies ; Humans ; Nephrotic Syndrome ; Pyelonephritis ; Renal Veins ; Thrombosis ; Tomography, X-Ray Computed ; Venous Thrombosis* ; Vomiting ; Warfarin

Interferon has been tried as a drug of choice in patients with chronic active hepatitis by hepatitis B virus infection since Greenberg has reported the effectiveness of interferon in 1976. The effects of interferon therapy have been reported variably and various complications such as fever, myalgia, arthralgia, flu-like symptoms, temporary leukopenia and thrombocytopenia, alopecia, cardiovascular symptoms and autoimmune diseases have been reported. But rhabdomyolysis has been rarely reported in the interferon therapy of chronic hepatitis B. There were some cases of rhabdomyolysis with acute renal failure in the interferon therapy which was designed for chemotherapy of malignant melanoma and for chronic active hepatitis C virus infection. We reported a case of rhabdomyolysis with acute renal failure developed during the interferon therapy in a patient with chronic active hepatitis B.
Acute Kidney Injury* ; Alopecia ; Arthralgia ; Autoimmune Diseases ; Drug Therapy ; Fever ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic* ; Humans ; Interferons* ; Leukopenia ; Melanoma ; Myalgia ; Rhabdomyolysis* ; Thrombocytopenia

OBJECTIVE: This study was aimed to characterize the clinical features and course of acute hepatitis A in Korean adults. METHODS: One-hundred and thirteen cases of acute hepatitis A, diagnosed between Jan. 1995 to July 1998 at 6 medical centers in Korea, were reviewed retrospectively. The clinical course of 94 cases with follow-up duration longer than 3 months were analyzed. RESULTS: The median age was 26 (16-65) years and 97.3% of the patients were under 40 years. The presumed sources of infection were identifed in 62 cases (54.9%). Among those, the leading source was ingestion of raw food. All patients showed normalization of bilirubin level within 8 weeks. The ALT levels normalized within 8 weeks in all patients except three patients (3.2%). Three patients with prolonged elevation of ALT showed second rise of ALT, suggesting a possibility of relapsing hepatitis. Prolonged fever (>38 degree C) more than 10 days was observed in 3 patients (3.2%). One case showed prolonged elevation of alkaline phosphatase (> x3 upper normal limit). No case of fulminant hepatic failure or death was observed. CONCLUSION: The majority of cases with acute hepatitis A in Korean adults showed self-limited course with full recovery.
Adult* ; Alkaline Phosphatase ; Bilirubin ; Eating ; Fever ; Follow-Up Studies ; Hepatitis A* ; Hepatitis* ; Humans ; Korea ; Liver Failure, Acute ; Retrospective Studies

PURPOSE: Small size of recombinant scFv antibody has many advantages such as rapid blood clearances and improved targeting antibodies to tumor region. On the other hand owing to small size, number of amino group is insufficient in conjugation with chelator and fluorescence labeling. This study is to introduce poly lysine tag to the C-terminal end of scFv lym-1 sequence for fluorescence chelator conjugation. MATERIALS AND METHODS: Poly lysine scFv lym-1 gene, cloned into pET-22b (+) vector, was expressed in E. coli BL21 (DE3) strain. Antibody purification was performed with Ni-NTA column and then size exclusion column chromatography. Expression and purification levels of poly lysine tagged scFv lym-1 antibody were confirmed by western blot analysis. I-124, I-125, I-131 and Tc-99m were used for radiolabeling of purified poly lysine scFv lym-1. Flow cytometry analysis of FITC conjugated poly lysine scFv lym-1 was performed for confirmation of immunoreactivity of human Burkitt`s lymphoma cells. RESULTS: Poly lysine scFv lym-1 antibody was purified through two steps and identified as molecular weight of 48 KDa. Radiolabeling yields of I-124, I-125, I-131 and Tc-99m into poly lysine scFv lym-1 were >99%, >99%, >95% and >99%, respectively. Flow cytometry analysis of poly lysine scFv and scFv lym-1 was showed similar immunoreactivity to human Burkitt`s lymphoma cells. CONCLUSION: Poly lysine tag was useful for the sufficient number of amino groups to scFv lym-1 antibody for chelator conjugation with minimizing loss of immunoreactivity.
Antibodies ; Blotting, Western ; Chromatography ; Clone Cells ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; Fluorescence ; Hand ; Humans ; Lymphoma ; Lysine ; Molecular Weight ; Sprains and Strains