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.

It is generally accepted that 1-3% of all inguinal hernias involve the bladder. However herniation of the bladder deep into the scrotum is rare. We report a case of massive bladder hernia of paraperitoneal type in a 58-year-old male with scrotal pain and palpable scrotal mass. Treatment consisted of partial cystectomy and herniorrhaphy. The postoperative result was good without complications.
Cystectomy ; Hernia* ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Male ; Middle Aged ; Scrotum* ; Urinary Bladder*

Retrograde jejunogastric intussusception defined as a segmental invagination of jejunal loop into stomach through stoma is a rare complication following partial gastric resection. Endoscopy and UGI series is very helpful in the diagnosis of this disease. Although the management of this disease is usually surgical, an endoscopic reduction can alternatively be attempted. If endoscopic reduction was failed, operation should be immediately per-formed in the acute type because of its high mortality. When anatomical reduction is done on due time, the prognosis is fairly good. We report a case of retrograde jejunogastric intussusception with a brief review of the literature. There was a 56 year old male patient who visited the hospital with chief complaints of severe epigastric pain and vomiting. He had subtotal gastrectomy for gastric carcinoma 6 years ago. On emergency endoscopy the type IIa jejunogastric intussusception was found. As the patient was suspected to be incar-cerated, surgical reduction was performed without delay. He was discharged on the 8th admission day.
Diagnosis ; Emergencies ; Endoscopy* ; Gastrectomy ; Humans ; Intussusception* ; Male ; Middle Aged ; Mortality ; Prognosis ; Stomach ; Vomiting

No abstract available.
Rectum*

A man and a woman were found dead in their parked car. The car was placed in a deep embankment. The windows were rolled up. Since it was cold winter the engine and heater was running while soil surrounded the rear of the automobile. The cause of death was 87%, 85% carbon-monoxide blood saturation respectively. The source of the CO was a defective exhaust system, The tail pipe outlet was blocked by the soil, and fumes could not escape adequately. Carbon monoxide fumes might entered the vehicle through the rusted floorboards, air conditioning, and through the dash board. It is important to know that unintened carbon monoxide deaths from motor vehicle exhaust can occur outdoors in older vehicles with defective exhaust system. We suggest the public need to be aware of the potential for this life threatening hazard to occur so that there can be proper prevention of fatalities.
Air Conditioning ; Automobiles ; Carbon Monoxide ; Cause of Death ; Female ; Humans ; Motor Vehicles ; Running ; Soil ; United Nations

No abstract available.
Choline*

BACKGROUND: Blood typing is an essential test for transfusion. Generally, blood typing is performed using a slide test, tube test or microcolumn agglutination test. The aims of this study were to develop a new blood typing kit using micromachining, microfluidics and microseparation methods, and to evaluate the clinical usefulness of the new blood typing kit. METHODS: We designed and manufactured a blood typing microchip using polydimethylsiloxane (PDMS), which contained a microchannel (25~200 micrometer). The blood sample and antisera to be tested were dropped on the microwell for movement and mixing by capillary action. Once agglutination occurred, the microchannel acts as a filter and the blood type was determined by observation by the naked eye. To evaluate the newtyping kit, we tested sensitivity using artificially diluted blood and compared the results of the new typing method with the slide and tube methods using 70 samples. RESULTS: The new blood typing kit could differentiate a +4~+2 agglutination reaction, but could not detect a +1 agglutination reaction as observed by the naked eye. Among 70 samples, the results of ABO and Rh typing by the new typing method (n=66, > or = +2 agglutination reaction by the column agglutination method) were in accord with the results of the tube and slide methods, but couldnot detect agglutination in all 4 clinical samples, below a +1 agglutination reaction. CONCLUSION: The new blood typing kit is inadequate for routine use in the clinical laboratory due to low sensitivity, but with further improvement, it can be used economically, conveniently and objectively for blood typing without any special equipment. Moreover, the microfludics and separation method may be broadly applicable in other tests using the hemagglutination method.
Agglutination ; Agglutination Tests ; Blood Grouping and Crossmatching* ; Capillary Action ; Hemagglutination ; Immune Sera ; Microfluidics* ; Microtechnology

Background/Aims: The effect of peroral endoscopic myotomy (POEM) on esophageal body movement in achalasia is poorly understood. This study aims to evaluate morphological changes in esophageal body movement after POEM in type III achalasia by analyzing intraluminal ultrasound (US) images in comparison to type I and II achalasia. Methods: Intraluminal US images and impedance values of the distal esophagus from 47 achalasia patients who underwent POEM or pneumatic dilatation (PD) (30 patients in the POEM group and 17 patients in the PD group) with pre- and post-procedural high-resolution impedance manometry and intraluminal US examinations were analyzed. The muscle thickness (MT), muscle cross-sectional area, lumen cross-sectional area (LCSA), contractility and distensibility indices, swallow-to-distension interval, and distension duration during each bolus transport were analyzed. Results: The MT increased and LCSA decreased significantly (P < 0.001), but the contractility index was not improved after POEM or PD in type I achalasia. Baseline MT increased and LCSA decreased significantly after POEM and PD in type II achalasia (P < 0.001). In contrast, MT and the swallow-to-distension interval decreased and the distension LCSA/duration and contractility index increased after POEM in type III achalasia (P < 0.001). In contrast to type I and II achalasia, in type III achalasia, these effects were unique to the POEM group. Conclusions POEM decreased the esophageal LCSA by decreasing intrabolus pressure without improving contractility in type I and II achalasia. In contrast, POEM increased esophageal body distension and contractility and improved the inhibitory process during bolus transport in type III achalasia.

PURPOSE: To evaluate the usefulness of ultrasonogram as a preoperative diagnostic tool in thyroid nodular diseases, this study was carried out. METHODS: From January 1998 to December 1999, 51 patients who underwent thyroidectomy were analyzed retrospectively. We compared the finally histopathological results to ultrasonographical findings such as internal consistency, multiplicity of nodules, nodular ehogenicity, nodular capsule or margin, calcification of nodules. RESULTS: There were 47 females and 4 males with 25 benign tumor, 23 malignant tumor and 3 occult carcinoma in histopathological diagnosis. The solid tumors in ultrasonography carried a probability of malignancy as 66.7% (16/24 cases) whereas cystic or mixed tumors as 16.7% (1/6 cases) or 23.8% (5/21cases) (p=0.006). The single nodular diseases carried a high probability of malignancy as 50% (13/26cases) whereas multiple diseases as 28.6% (6/21 cases). The hypoechogenicity of thyroid nodular disease showed a probability of malignancy as 60% (9/15 cases) whereas mixed-echogenicity as 36.4% (4/11 cases). The nodules with poorly-defined margin in ultrasonographic findings showed higher probability of malignancy as 63.6% (7/11cases) than the nodules with well -defined margin as 26.5% (9/34 cases) (p=0.025). The nodules with calcification in ultrasonographic findings were represented to high probability of malignancy as 70.6% (12/17 cases) compared to those without calcification as 29.4% (10/34 cases) (p=0.005). The differency between ultrasonic and histopathological diagnosis was high in solid nodules (33%), 3~4 cm sized nodules (28.6%) and mixed echogenecity (27.3%) whereas low in complex nodules with cystic and solid nature (4.8%), 2~3 cm sized nodules (8.3%) and pooly defined margin (9.1%). The accuracies of sonography in differentiating malignacy from benign thyroid nodules were 7.1% of false positivity, 39.1% of false negativity, 60.9% of sensitivity, 92.9% of specificity and 78.4% of accuracy. CONCLUSION: Sonographic examination was relatively excellent test as a preoperative diagnostic tool in thyroid nodular diseases when detailed checklists were applied such as internal consistency, multiplicity of nodules, nodular ehogenicity, nodular capsule or margin and calcification of nodules.
Checklist ; Diagnosis ; Female ; Humans ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonics ; Ultrasonography*

PURPOSE: In major burns, deep vein thrombosis (DVT) is frequently diagnosed as a major complication of burns. But the risk factors and prophylaxis remain controversial. This study was designed to evaluate the incidence and risk factors of DVT in major burn patients. METHOD: We reviewed all major burn patients (>40% of TBSA) admitted to our burn center from June 1998 to August 2003 and assessed each affected patients with an in-hospital diagnosis of DVT for DVT risk factors. RESULT: There were 9 symptomatic DVT detected among 606 severe burn patients (1.45% incidence). Patients diagnosed with DVT had no risk factors of morbid obesity, previous DVT, congestive heart failure or neoplastic disease, except one patient who had a polycythemia vera diagnosed incidentally. In eight of 9 patients, DVT occurred in veins draining burned extremities. All patients had burn wound infections as a complication of burns. Eight of 9 patients had longer hospital stays than patients without DVTs. In all patients, DVT was developed after operations for skin graft. CONCLUSION: DVT should be suspected in patients with delayed wound healing and unresolved edema of extrimites. Wound infection, long bed-ridden state and operations are significant risk factors for DVT formation in major burn patients.
Burn Units ; Burns* ; Diagnosis ; Edema ; Extremities ; Heart Failure ; Humans ; Incidence ; Length of Stay ; Lower Extremity* ; Obesity, Morbid ; Polycythemia Vera ; Risk Factors ; Skin ; Transplants ; Veins ; Venous Thrombosis* ; Wound Healing ; Wound Infection