BACKGROUND: With progressive improvement in the fraction of long-term surviviors, chronic GVHD has emerged as a increasingly frequent complication of allogenic bone marrow transplantation. Except for a few case reports, there has been no clinical study of chronic cutaneous GVHD in Korea so far. OBJECTIVE: In the present study we planned to investigate the clinical characteristics of chronic cutaneous GVHD and to compare the clinical manifestation and incidence of chronic cutaneous GVHD in Korea with previous reports in U.S.A. and Europe. METHODS: On the basis of the patients' charts and the records of bone marrow transplantation, we investigated the incidence of chronic cutaneous GVHD in Korean leukemia patients and studied the clinical manifestations of chronic cutaneous GVHD ocurring in 16 patients whose diagnosis was confirmed by histopathologic findings of skin biopsy. We also analysed whether total body irrdiation before bone marrow transplantation, GVHD prophylaxis and presence of preceding acute GVHD affected chronic cutaneous GVHD. RESULTS: 1. The incidence in chronic cutaneous GVHD in Korea was lower than that in Caucasian countries. 2. The onset was milder than that in Caucasians. 3. The clinical manifestation was earlier than that in Caucasians. 4. The relationship between the GVHD prophylaxis and incidence chronic cutaneous GVHD was not significant. 5. The incidence of chronic cutaneous GVHD in the presence of preceding acute GVHD was higher than in cases with no preceding acute GVHD. CONCLUSION: We speculate that the low incidence of chronic cutaneous GVHD and clinical characteristics differing from the reports in the U.S.A. and Europe might be unassociated with irradiation, GVHD prophylaxis or the presence of preceding acute GVHD but maybe related to differences in genetic background.
Biopsy ; Bone Marrow Transplantation ; Diagnosis ; Europe ; Humans ; Incidence ; Korea ; Leukemia ; Skin

BACKGROUND AND OBJECTIVES: Hypercholesterolemia is a key factor in the development of atherosclerosis. We sought to evaluate the relation between hypercholesterolemia and plaque composition in patients with coronary artery disease. SUBJECTS AND METHODS: Study subjects consisted of 323 patients (mean 61.5 years, 226 males) who underwent coronary angiography and virtual histology-intravascular ultrasound examination. Patients were divided into two groups according to total cholesterol level: hypercholesterolemic group (> or =200 mg/dL, n=114) and normocholesterolemic group (<200 mg/dL, n=209). RESULTS: Hypercholesterolemic patients were younger (59.7+/-13.3 years vs. 62.6+/-11.5 years, p=0.036), than normocholesterolemic patients, whereas there were no significant differences in other demographics. Hypercholesterolemic patients had higher corrected necrotic core volume (1.23+/-0.85 mm3/mm vs. 1.02+/-0.80 mm3/mm, p=0.029) as well as percent necrotic core volume (20.5+/-8.5% vs. 18.0+/-9.2%, p=0.016) than normocholesterolemic patients. At the minimal lumen area site, percent necrotic core area (21.4+/-10.5% vs. 18.4+/-11.3%, p=0.019) and necrotic core area (1.63+/-1.09 mm2 vs. 1.40+/-1.20 mm2, p=0.088) were also higher than normocholesterolemic patients. Multivariate linear regression analysis showed that total cholesterol level was an independent factor of percent necrotic core volume in the culprit lesion after being adjusted with age, high density lipoprotein-cholesterol , hypertension, diabetes mellitus, smoking and acute coronary syndrome (beta 0.027, 95% confidence interval 0.02-0.053, p=0.037). CONCLUSION: Hypercholesterolemia was associated with increased necrotic core volume in coronary artery plaque. This study suggests that hypercholesterolemia plays a role in making plaque more complex, which is characterized by a large necrotic core, in coronary artery disease.
Acute Coronary Syndrome ; Atherosclerosis ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Demography ; Diabetes Mellitus ; Humans ; Hypercholesterolemia ; Hypertension ; Linear Models ; Smoking

Mucinous cystadenocarcinoma (MC) of the kidney is a rare epithelial tumor originating from the renal pelvic urothelium and few study cases have been reported. Because of the rarity of these tumors and their unknown histogenesis, its diagnosis is difficult until surgical exploration. We report here on a 55-year-old man referred to the urology department from the hepatology department because of a cystic renal mass measuring approximately 5 cm in size, which was detected incidentally under ultrasonography during the routine examination of liver. The renal mass was finally diagnosed as MC originating from kidney after partial nephrectomy and the patient still showed no evidence of recurrence until 12 months postoperatively. This is the first report on a case of renal MC in a patient who underwent partial nephrectomy. The aim of this report is to present our unusual case of MC and also review the previous literature on the pathological and radiological aspects of MC of kidney.
Cystadenocarcinoma, Mucinous* ; Diagnosis ; Gastroenterology ; Humans ; Kidney* ; Liver ; Middle Aged ; Mucins* ; Nephrectomy* ; Recurrence ; Ultrasonography ; Urology ; Urothelium

The peneicillin binding protein gene(mecA gene) is present in the methicillin-resistant Staphylococcus strains but not in the susceptible ones. The goal of the present study was to establish experimental evidences which might use polymerase chain reaction(PCR) for culture confirmation and eventually clinical diagnosis of methicillin resistant Staphylococcui. Two primers (5'-AAAATCGATGGTAAAGGTTGGC-3', 5'-AGTTCTGCAGTACCGGATTTGC-3') based on the known DNA sequence of the mecA gene from methicillin-resistant Staphylococcus aureus were used in PCRs to screen for the presence of this gene in Staphylococcal isolates from various clinical settings. When the primers were used to copy the DNA of the mecA gene, only 533 base-pair DNA fragment was appeared. The product indicates a positive PCR result for methicillin-resistant Staphylococcal isolates. In contrast, from the DNA of the methicillin-sensitive Staphylococcal isolates the 533bp was not amplified. Results obtained with PCR were generally consistent with those of standard microbiological assays. The mecA gene in methicillin-high resistant Staphylococci was located on the approximately 5.56kb Hind III restriction fragment. The 533bp probe was hybridized to the 5.56kb Hind III restriction fragment of mecA-positive S. aureus. No hybridization was occured in the mecA-negative strain. The mecA gene was cloned, named pHL-1201 and verified by colony hyhridization. The 533bp probe was hybridized to the approximately 5.56kb Hind III restriction fragment of the DNA obtained from pHL-1201. PCRs with the primers successfully distinguished methicillin-resistants from methicillin-susceptible strains of S. aureus and S. epidermidis.
Base Sequence ; Carrier Proteins ; Clone Cells* ; Cloning, Organism* ; Diagnosis ; DNA ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus ; Polymerase Chain Reaction* ; Staphylococcus aureus ; Staphylococcus*

BACKGROUND AND OBJECTIVES: Both carotid intima-media thickness (CIMT) and carotid plaque are important factors in the primary prevention of cardiac disease. However, it is unclear which one is more important for prognosis, especially in patients with coronary artery disease (CAD). SUBJECTS AND METHODS: In total, 1426 consecutive CAD patients, proven by angiography, were followed-up for a mean of 85 months. The study population was divided into four groups depending on the CIMT (> or =0.83 mm, >95 percentile in Korea) and the presence or absence of carotid plaque. RESULTS: Patients with carotid plaque and thick CIMT (n=237, 16.6%) had a higher prevalence of hypertension, diabetes mellitus, and dyslipidemia than those had plaque and thin CIMT (n=213, 14.9%), those without plaque and thick CIMT (n=265, 18.6%) and those without plaque and thin CIMT (n=711, 49.9%). The patients with carotid plaque and thick CIMT group had a higher cardiac mortality rate (20.7% vs. 13.1%, 9.4% and 3.9%, respectively, p<0.001) and higher major adverse cardiovascular events (MACE) including death, acute myocardial infarction, and stroke (27.8% vs. 18.8%, 15.5% and 9.3%, respectively, p<0.001) than any other groups. Multivariate Cox regression analysis showed that the presence of carotid plaque with thick CIMT had the highest hazard ratio (HR) compared to other groups (HR 2.23 vs. 1.81, 2.01) for cardiac mortality. Also, carotid plaque had a higher HR than CIMT for mortality (HR 1.56 vs. 1.37) and MACE (HR 1.54 vs. 1.36) in the total study population. CONCLUSION: Carotid plaque is a more important prognostic factor than CIMT in patients with CAD, and adding a thick CIMT to carotid plaque increases the prognostic power for cardiac events.
Angiography ; Carotid Intima-Media Thickness ; Carotid Stenosis ; Coronary Artery Disease* ; Diabetes Mellitus ; Dyslipidemias ; Follow-Up Studies* ; Heart Diseases ; Humans ; Hypertension ; Mortality ; Myocardial Infarction ; Prevalence ; Primary Prevention ; Prognosis ; Stroke ; Ultrasonography*

BACKGROUND AND OBJECTIVES: The relationship between the positive remodeling (PR) of a coronary artery and plaque composition has been studied only in a relatively small number of study population or non-culprit lesion. We evaluated the association between coronary plaque composition and coronary artery remodeling in a relatively large number of culprit lesions. SUBJECTS AND METHODS: The study population consisted of 325 consecutive patients with coronary artery disease that underwent intravascular ultrasound-virtual histology examination in a culprit lesion. The remodeling index (RI) was calculated as the lesion external elastic membrane (EEM) area divided by the average reference EEM area. RESULTS: The lesions with PR (RI>1.05, n=97, mean RI=1.19+/-0.12) had a higher fibrous volume/lesion length (3.85+/-2.12 mm3/mm vs. 3.04+/-1.79 mm3/mm, p=0.003) and necrotic core volume/lesion length (1.26+/-0.89 mm3/mm vs. 0.90+/-0.66 mm3/mm, p=0.001) than those with negative remodeling (NR) (RI<0.95, n=132, mean RI=0.82+/-0.09). At the minimal luminal area site, the lesions with PR had a higher fibrous area (5.81+/-3.17 mm2 vs. 3.61+/-2.30 mm2, p<0.001), dense calcified area (0.73+/-0.69 mm2 vs. 0.46+/-0.43 mm2, p=0.001), and necrotic core area (1.93+/-1.33 mm2 vs. 1.06+/-0.91 mm2, p<0.001) than those with NR. RI showed significant positive correlation with fibrous volume/lesion length (r=0.173, p=0.002), necrotic core volume/lesion length (r=0.188, p=0.001), fibrous area (r=0.347, p<0.001), fibrofatty area (r=0.111, p=0.036), dense calcified area (r=0.239, p<0.001), and necrotic core area (r=0.334, p<0.001). Multivariate analysis showed that the independent factor for PR was the necrotic core volume/lesion length (beta=0.130, 95% confidence interval; 0.002-0.056, p=0.037) over the entire lesion. CONCLUSION: This study suggests that PR in a culprit lesion is associated with the necrotic core volume in the entire lesion, which is a characteristic of vulnerable plaque.
Atherosclerosis ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Membranes ; Multivariate Analysis ; Phenobarbital ; Ultrasonography, Interventional

BACKGROUND AND OBJECTIVES: The coronary vasospasm has been shown to play an important role in the pathogenesis of not only variant angina but also ischemic heart disease in general, including other forms of angina pectoris, acute myocardial infarct, and sudden death. The angiographic features of coronary vasospasm are focal and diffuse patterns in clinical setting. We attempted to clarify the differences in vessel wall morphologic appearance between the sites of focal and diffuse vasospasm by intravascular ultrasound(IVUS). MATERIAL AND METHODS: We studied 23 patients(32 segments) with variant angina in whom coronary angiograms were normal and coronary spasm was documented by intracoronary injection of acetylcholine. Coronary spasm was defined as luminal diameter reduction > or = 90% compared with baseline coronary artery diameter. Focal spasm was defined if the length of spastic narrowing was less than 10mm. By IVUS, we observed atheromatous plaques in 32 spasm segments with either focal or diffuse vasospasm. We measured maximal intimal thickness, luminal cross-sectional area(CSA), and external elastic membrane-CSA in spasm sites. RESULT: When comparing maximal intimal thickness between focal (n=15) and diffuse vasospasm segments(n=17), there was significantly greater thickness at focal spasm segments(1.21+/-0.36mm vs. 0.70+/-0.23mm, P<0.001). The maximal plaque area was similar between two groups but tended to be greater in focal spasm segments(6.03+/-2.06mm2 vs. 4.92+/-2.59mm2, P=NS). When circular shaped factor(CSF : standardized index of eccentricity) was compared, focal spasm segments were greater than diffuse spasm segments(0.89+/-0.06 vs. 0.97+/-0.02, P<0.001). At the segments of focal spasm, remodeling index was greater compared to the segments of diffuse spasm(1.02+/-0.16 vs. 0.86+/-0.13, P<0.001). CONCLUSION: Focal spasm segments were more eccentric and had greater atheromatous plaque than diffuse spasm segments. Positive remodeling pattern was observed at the segments of focal spasm and negative remodeling pattern at the segments of diffuse spasm. There were morphologic differences of vessel wall appearance between focal and diffuse spasm sites.
Acetylcholine ; Angina Pectoris ; Coronary Vasospasm* ; Coronary Vessels ; Death, Sudden ; Muscle Spasticity ; Myocardial Infarction ; Myocardial Ischemia ; Phenobarbital ; Plaque, Atherosclerotic ; Spasm

PURPOSE: This study was undertaken to reveal the molecular mechanism underlying sulindac-induced apoptosis in the human colon cancer cell line HT-29 (mutant p53). METHODS: Apoptosis was determined by using Hoechst 33342 staining, and translocation of proteins was established by using immunofluorescence, immunoelectron microscopy, and Western blotting after ultra- fractionation. RESULTS: This type of apoptosis was associated with decreased mitochondrial membrane potential, a translocation of the apoptosis-inducing factor (AIF) to the nucleus, and morphological evidence of nuclear condensation. However, DNA electrophoresis did not elucidate the ladder pattern of DNA fragments. Instead, a pulse-field gel electrophoresis showed that sulindac led to disintegration of nuclear DNA into-high- molecular-weight DNA fragments of about 100~300 kbp. CONCLUSIONS: Our findings indicate that sulindac induces large-scale DNA fragmentation, suggesting a predominantly AIF-mediated cell-death process, through translocation of the AIF to the nucleus in HT-29 cells.
Apoptosis Inducing Factor ; Apoptosis* ; Blotting, Western ; Cell Line ; Colonic Neoplasms ; DNA Fragmentation* ; DNA* ; Electrophoresis ; Fluorescent Antibody Technique ; HT29 Cells* ; Humans ; Membrane Potential, Mitochondrial ; Microscopy, Immunoelectron ; Sulindac

BACKGROUND AND OBJECTIVES: Radiation therapy is one of the promising new treatment for restenosis, which is a major problem for the long-term success after angioplasty. We compared radiation therapy only and combined therapy of paclitaxel and radiation on neointimal hyperplasia after injury of rat carotid artery to see whether we can reduce the effective dosage of radiation and thus diminish untoward consequence of radiation if paclitaxel could function as a cell-cycle selective radiosensitizer. MATERIAL AND METHODS: A standardized carotid balloon catheter arterial injury was produced in 65 rats. First group was composed of a single dose of paclitaxel 1 mg/kg body weight, 2 mg/kg or 4 mg/kg, which was administrated intraperitoneally at 2 hours after injury. Second group received external radiation at doses of 2.5 or 5 Gy at 24 hours after injury. Third group was treated with combined paclitaxel-radiation: paclitaxel was injected at 2 hours after injury and then external radiation was delivered 24 hours later. At 21 days after injury, the cross-sectional area of neointima and the ratio of intima/medial area were determined from axial sections using image analysis. RESULTS: Single dose of paclitaxel had no effect in reducing smooth muscle cell proliferation. Minimum effective single dose to inhibit neointimal hyperplasia was 5 Gy. Combined paclitaxel-radiation group except subgroup with paclitaxel 1 mg/kg and 2.5 Gy radiation showed significant reduction of neointimal area compared to group with 2.5 Gy radiation. CONCLUSION: Low-dose external radiation combined with paclitaxel can more effectively inhibit smooth muscle cell pro-liferation and neointimal hyperplasia than radiation only in the rat carotid injury model.
Angioplasty ; Animals ; Body Weight ; Carotid Arteries ; Catheters ; Hyperplasia* ; Myocytes, Smooth Muscle ; Neointima ; Paclitaxel* ; Radiation Dosage ; Rats*

The characteristics of pesticide residues were examined in 18,069 samples from 91 vegetable commodities collected in Seoul from 2007 to 2009, and the vegetable dietary intakes of Seoulites were estimated using the Korea National Health and Nutrition examination survey data from 2008. The hazard index was calculated using vegetable pesticide residues and dietary vegetable intake by Seoulites. Detection rates for pesticide residues in vegetables were 11.2 % in 2007, 8.6 % in 2008, and 12.0 % in 2009. Excess rate of Maximum Residue Limits tended to decline from 4.6 % in 2007, to 2.8 % in 2008, and 2.1 % in 2009. Daily vegetable intake for Seoulites was 288.12 +/- 214.8 g, and vegetable intake by males was more than that of females (p < 0.001). The hazard index was the highest at 2.76 x 10(-2) in 2007, and the lowest at 1.69 x 10(-2) in 2009. The risks caused by multiple pesticides in vegetables were very low and vegetable intake was safe considering the hazard index values.
Female ; Humans ; Korea ; Male ; Nutrition Surveys ; Pesticide Residues ; Pesticides ; Vegetables