No abstract available.
Aspergillosis*

PURPOSE: We report seven cases of pancreas transplantation, first performed in Korea, in the context of postsurgical radiologic studies. MATERIALS AND METHODS: All patients with insulin-dependent diabetes mellitus received transplants from cadevaric(n=6) or living related donor(n=1). Retrospective analysis of 27 US(including 19 Duplex US), two CT, four MRi, and three scintigraphy for these patients was made with surgico-pathological correlation in five cases. RESULT:Of the seven patients, three-month graft survival was five and one-year survival was two. One patient died of abdominal abscess following surgery. US gave the valuable informations regarding the graff swelling, vascular complication, and perigraff fluid collection. RBC bleeding scan was effective of the presence or absence and location of intestinal bleeding. CT was useful in determining the extent and severity of the pancreatitis. MRI gave a little information about functional status of the grafted pancreas. CONCLUSION: The choice of appropriate imaging modalities for postsurgical work up in patients who had pacreas transplantation depends on the clinical conditions of the patients and complications suspected. Further prospective studies appear to be necessary to eatablish the interval and modality choice for early detection of the complication.
Abdominal Abscess ; Diabetes Mellitus, Type 1 ; Graft Survival ; Hemorrhage ; Humans ; Korea ; Magnetic Resonance Imaging ; Pancreas Transplantation* ; Pancreas* ; Pancreatitis ; Radionuclide Imaging ; Retrospective Studies ; Transplants

BACKGROUND AND OBJECTIVES: Compared to other target cells examined for gene therapy, vascular smooth muscle cells (VSMCs) have the unique advantages including proximity to blood stream and relative abundance in vasculature. With an ultimate goal of developing VSMC-based therapies for cardiovascular disorders, we explored the utility of VSMC as a target cell for ex vivo gene therapy using a set of retroviral vectors. MATERIALS AND METHODS: Cultured VSMCs were transduced with replication-defective recombinant retroviruses harboring LacZ, nlsLacZ, mVEGF, mGM-CSF or bacterial CAT reporter. The VSMCs were examined for G418-selection, transduction efficiency, the level of transgene expression, and longevity of gene expression. ResultsVSMCs were readily transduced with different kinds of retroviral vectors. The bacterial neo r gene-transduced VSMCs were successfully selected with G418. The G418-selected VSMCs could express the transduced genes at a level comparable to NIH3T3. The level of transgene expression did not appear to be affected by the increasing number of passages. CONCLUSION: The results demonstrate an efficient transduction of VSMCs by retroviral vectors in vitro and an sustained expression of retrovirally transduced genes in VSMCs. VSMCs could be one of the ideal target cells for ex vivo cardiovascular gene therapy employing retroviral vector.
Animals ; Cats ; Gene Expression ; Genetic Therapy* ; Longevity ; Muscle, Smooth, Vascular* ; Retroviridae ; Rivers ; Transgenes ; Zidovudine

PURPOSE: In children with simple obesity, spontaneous and stimulated growth hormone (GH) secretion are diminished, but their heights usually are normal or even taller for their age and sex. The exact mechanism to explain the discrepancy between impaired GH secretion and normal height velocity has not been elucidated. In this study, we aimed to determine the level of serum growth factors, and the degree of insulin-like growth factor binding protein (IGFBP)-3 proteolysis, and to assess the alteration of the IGF system associated with accelerated or normal growth in simple obesity. METHODS: We evaluated serum growth factors, and IGFBP-3 proteolysis in 27 obese, 25 obesity risk group, and 28 age-matched control group. We measured serum levels of insulin-like growth factor (IGF)-I, IGFBP-1, -3, and free IGF-I by immuno-radiometric assay and IGFBP-3 fragment by Western immunoblotting. RESULTS: The height was taller in obese children than in lean control group. The results showed no significant difference in the level of serum total IGF-1 and IGFBP-3 between obese and normal control group. Although there was no significant difference in other components, serum free IGF-I levels were significantly increased (P<0.05) and showed positive correlation with their height in obese children (r=0.25, P<0.05). The degree of IGFBP-3 proteolysis was increased in obesity and obesity risk group compared to control group. The densities of the IGFBP-3 proteolytic fragment approximate 18 kDa also showed positive correlation with levels of free IGF-I (r=0.23, P<0.05) and height (r=0.19, P<0.05). CONCLUSION: These findings may suggest that elevated levels of serum IGFBP-3 proteolytic fragments showing decreased affinity to IGF-I result in the increase of biologically active free IGF-I, thereby maintain normal growth in the obese children.
Blotting, Western ; Carrier Proteins ; Child* ; Growth Hormone ; Humans ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Obesity* ; Proteolysis*

Prader-Willi syndrome is a well known multi-systemic disorder featuring hypothalamic dysfunction and hypotonia with underlying chromosomal anomaly. High morbidity, early mortality due to complications as diabetes mellitus, hypertension, athero-sclerosis, and cardio-respiratory failure have been reported from poorly tolerated obesity and combined metabolic disorders. We experienced a 20-year- old girl with Prader-Willi syndrome diagnosed at the age of 7. She underwent massive, uncontrolled weight gain despite constant multi-drug therapy including human recombinant growth hormone, orlistat, sibutramine and combined behavioral managements. Her body weight reached 104 kg and she developed dyslipidemia, fatty liver, hypertension, diabetes mellitus and episodes of sleep apnea. She showed no significant response to the supportive treatment because of characteristic involvement in CNS especially hypothalamus and psycho-behavioral disorders. As Bariatric surgery was the most effective and curative method in treatment of severe morbid obesity, Roux-en-Y gastric bypass was performed. After the operation, she showed substantial weight loss and consequent improvements in obesity related complications. She could stop all medications concerning for obesity. We report a case of bariatric surgery on a girl with Prader-Willi syndrome and combined severe morbid obesity who underwent bariatric surgery which resulted in marked weight loss and improvements in associated complications.
Bariatric Surgery* ; Body Weight ; Diabetes Mellitus ; Dyslipidemias ; Fatty Liver ; Female ; Gastric Bypass ; Growth Hormone ; Humans ; Hypertension ; Hypothalamus ; Mortality ; Muscle Hypotonia ; Obesity ; Obesity, Morbid* ; Prader-Willi Syndrome* ; Sleep Apnea Syndromes ; Weight Gain ; Weight Loss

Chromosomal polymorphism of constitutive heterochromatin regions of chromosome 1, 9, 16, and Y is a stable evolutionary feature that is thought to cause no phenotypic alterations. The presence of definite ethinic and age-related peculiarities of chromosomal polymorphism variants was established. Some authors reported the relationship of the separate variants with the phenotypic characteristics, such as reproductive function, physiological and anthropometric indices, and oncological diseases. Nevertheless, the role of constitutive heterochromatin is still unknown. We experienced and reported short children associated with polymorphisms in chromosme 1qh+ and 16qh+.
Child ; Chromosomes, Human, Pair 1 ; Heterochromatin ; Humans

PURPOSE: Zinc is an essential nutrient, which is required to maintain the normal structure and/or function of multiple enzymes. Therefore, zinc nutriture has been known to influence the physical growth of young children. This study was desinged to evaluate the relationship between blood zinc levels and growth parameters in children. METHODS: Two hundred eighty three children (150 boys and 133 girls) who visited the Youngdong Severance Hospital as short stature were enrolled in this study. Height standard deviation score (Ht. SDS), weight standard deviation score (Wt. SDS), and pubertal stage were obtained for each children. Blood samples were collected for zinc, alkaline phosphatase (ALP), insulin-like growth factor binding protein-3 (IGFBP-3), insulin-like growth factor-1 (IGF-1), and free thyroxine (fT4). The relationship between blood zinc levels and growth status, and growth factors were analyzed. RESULTS: The Ht. SDS and Wt. SDS were -0.16+/-0.99, 0.16+/-0.88 respectively for the low blood zinc level group; the Ht. SDS and Wt. SDS were -0.16+/-0.97, 0.08+/-0.93 respectively for the normal blood zinc level group. Between two groups, Ht. SDS, Wt. SDS, bone age, pubertal stage, ALP, and IGF-1 showed no significant differences, while IGFBP-3 and fT4 showed significant differences (P<0.05). The mean zinc concentrations showed no significant difference between the normal stature group and short stature group (101.60+/-41.11 microgram/dL, 93.72+/-35.38 microgram/dL respectively). The Ht. SDS, Wt. SDS, pubertal stage, ALP, and IGF-1 showed no significant correlation with the zinc levels, while the IGFBP-3 and fT4 showed significant correlation (P<0.05). CONCLUSION: We could not find any significant relationship between blood zinc level and growth status. However, interpretation of our results should be cautious in aspect that the result might come from the subjects with mild zinc deficiency. Further study is required to investigate the severe zinc deficiency patients and zinc replacement study.
Alkaline Phosphatase ; Child* ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Thyroxine ; Zinc*

No abstract available.

PURPOSE: This study was attemped to investigate the prognostic factors for the outcome of stage I renal cell carcinoma after radical nephrectomy. MATERIALS AND METHODS: Twenty nine patients treated from 1984 to 1995 at Kyung Hee University Medical Center were studied retrospectively. All of them were diagnosed with pathologic Robson stage I renal cell carcinoma after radical nephrectomy. RESULTS: Males were affected three times more frequently than females. The tumor was detected on the right kidney in 15 cases, and on the left in 14. Average follow up period was 36.6 months, average disease free interval was 29.4 months and median survival was 30 months. During the follow up, 9 patients (31.0%) expired due to liver and lung metastasis at postoperate 21.6 months on average. Eleven patients (37.9%) developed distant metastasis in the follow up. There was no local recurrence of tumor. Seventeen patients were diagnosed incidentally without clinical symptoms. In our retrospective study for stage I renal cell carcinoma, there were no predictive prognostic parameters for predicting the outcome of patients, except for the incidental diagnosis of the tumor. CONCLUSIONS: These results suggest that incidental diagnosis of the tumor may be the most important prognostic factor for the outcome of stage I renal cell carcinoma. Although the patients were confirmed as stage I renal cell carcinoma pathologically after radical nephrectomy, close follow up is very important, because of high incidence of metastasis. We recommand that chest X-ray, abdominal ultrasonogram and bone scan should be checked at 3 months interval for postoperative one year even though stage I renal cell carcinoma.
Academic Medical Centers ; Carcinoma, Renal Cell* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney ; Liver ; Lung ; Male ; Neoplasm Metastasis ; Nephrectomy ; Recurrence ; Retrospective Studies ; Thorax ; Ultrasonography

OBJECTIVE: To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: The blood samples of patients with recurrent spontaneous abortion were tested by PCR-RFLP method. RESULTS: Of 51 cases of study group, 14 (27.5%) were normal, 25 (49.0%) were heterozygosity, and 12 (23.5%) were homozygosity. Of 58 cases of control group, 20 (34.5%) were normal, 30 (51.7%) were heterozygosity, and 8 (13.8%) were homozygosity. But the difference between two groups was not significant (p=0.190). CONCLUSION: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the study for MTHFR mutation should be included in the workup of recurrent spontaneous abortion.
Abortion, Spontaneous* ; Female ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy