OBJECTIVES: MDM-2 is an oncoprotein that inhibits p53 tumor suppressor protein. Amplication and over- expression of its protein have been observed in human malignancies, and these abnormalities have a role in tumorigenesis through inactivation of p53 function. To elucidate the role of p53 and MDM-2 protein in cervical neoplasia we investigated the expression rates of MDM-2 and p53 protein in surgically resected specimens. METHEDS: Immunohistochemical studies using anti-p53 and anti-MDM-2 protein in the paraffin embedded section of 62 cases including cervical intraepithelial neoplasm(CIN) and invasive cervical cancer were performed. RESULTS: Expression rates of p53 protein were 25% in CIN I& CINII, 20% in CINIII, and 44% in invasive carcinoma, respectively. The MDM-2 protein were 33% in CIN I & CIN II, 16% in CIN III, and 48% in invasive carcinoma, respectively. There was no evident correlation between p53 positivity and MDM-2 positivity(p>0.05). However, correlation between MDM-2 negativity and p53 negativity was statistically significant(p=0.002) CONCLUSION: These data suggest that the expression of p53 protein is presumed to be necessarily correlated with MDM-2 protein expression in cervical neoplasia.
Carcinogenesis ; Humans ; Paraffin ; Proto-Oncogene Proteins c-mdm2* ; Tumor Suppressor Protein p53 ; Uterine Cervical Neoplasms

Neonatal diabetes mellitus (NDM) is defined as hyperglycemia that presents clinical symptoms within the first month of life and requires insulin therapy to maintain euglycemia. The diabetic condition may be transient, permanent, or transient with recurrence later in life. NDM is a rare clinical disorder. Three cases of NDM have been reported in Korea so far. We experienced two cases of NDM in twin brothers who were born with small for gestational ages. Their HLA typings were DR9 and DR14, and insulin autoantibody, islet cell antibody, GAD-reactive autoantibody, and insulin receptor antibody were not found. The genetic analysis with polymorphic DNA markers for chromosome 6 indicated paternal uniparental isodisomy.
Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Gestational Age ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Insulin ; Islets of Langerhans ; Korea ; Receptor, Insulin ; Recurrence ; Siblings* ; Twins* ; Uniparental Disomy

A 5-year-old male patient was admitted due to fever, and right upper abdominal pain for 2 weeks. He showed severe right upper quadrant tenderness on palpation, hepatomegaly 5 cm below the right costal margin, no mass, and no splenomegaly. On biochemical studies, ALT was 380IU/ml, AST 462IU/ml, alkaline phosphatase 1,069IU/ml, GTP 239IU/ml, and total bilirubin 2.1mg/dl. Endoscopic retrograde cholangiopancreatography (ERCP) showed cylindrical dilatations of CBD and cystic dilatations with strictures of extrahepatic and both bilateral intrahepatic bile ducts (choledochal cyst type IVa) with multiple stones in the CBD and extra- and intrahepatic bile ducts. Endoscopic sphincterotomy (EST) and stone extraction with basket and balloon were performed successfully. The bile was severely purulent and the stones were pigment stones. Klebsiella pneumoniae were dominantly grown on bile culture. An endoscopic nasobiliary drainage (ENBD) tube was inserted to treat biliary sepsis. The bile ducts were irrigated with tobramycin-mixed normal saline twice a day for 2 week, when ALT, AST, total bilirubin and liver size were normalized and no more bacteria was grown on bile culture. The clinical symptoms were improved just after the therapeutic ERCP. There was no side effect by ERCP, EST and ENBD.
Abdominal Pain ; Alkaline Phosphatase ; Bacteria ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Bilirubin ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis* ; Choledochal Cyst* ; Choledocholithiasis* ; Constriction, Pathologic ; Dilatation ; Drainage* ; Fever ; Guanosine Triphosphate ; Hepatomegaly ; Humans ; Klebsiella pneumoniae ; Liver ; Male ; Palpation ; Sepsis ; Sphincterotomy, Endoscopic ; Splenomegaly

10 Patients with primary hypercholesterolemia were treated for 12 weeks with lovastation(20mg t.i.d). Lovastatin reduced mean total and low density lipoprotein cholesterol by 43% and 57% respectively(p<0.001). High density lipoprotein cholesterol and triglyceride levels were unchanged by the drug. Adverse effects attributable to lovastatin were not observed. Thus lovastatin is considered as an effective lipid lowering agent for the treatment of primary moderate hypercholesterolemia.
Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hypercholesterolemia* ; Lovastatin* ; Triglycerides

OBJECTIVES: This study was performed to investigate the relationship between cell counts, supernatant and lysate ECP levels in sputum, and physiologic markers in adult asthmatics. METHODS: Twenty-two patients with mild to moderate persistent asthma, ten patients with acute exacerbated asthma and nine healthy subjects were enrolled. Sputum was induced by inhalation of hypertonic saline, and homogenized with 0.1% dithiothreitol. A total and differential cell was measured. The remnant cell suspension was centrifuged, and ECP (supernatant ECP) was measured in supernatant fluid. Cell pellet was reacted with a cellular lysis buffer to release cell-associated ECP, and ECP (lysate ECP) was measured again in supernatant fluid. The ratio of supernatant to lysate ECP was calculated as an index of eosinophil degranulation. Spirometry and methacholine bronchial challenge tests were also performed as physiological markers of asthma. RESULTS: The patients with acute exacerbated asthma showed significantly higher percentage of sputum neutrophil, eosinophil count, concentration of sputum supernatant ECP and ratio of supernatant to lysate ECP than those of normal controls and stable asthmatic patients(p < 0.05, respectively). The level of sputum supernatant ECP, supernatant/lysate ECP ratio, and percentage of neutrophil showed negative correlations with pulmonary functions, but no correlations with a degree of bronchial hyperresponsiveness. There was no significant correlations between of serum ECP level and physiological parameters. CONCLUSION: These results suggest that both neutrophils and eosinophils play roles in the exacerbation of asthma. The sputum supernatant/lysate ECP ratio might be valuable in assessment of activation status of eosinophils in various hypereosinophilic conditions or diseases.
Adult* ; Asthma* ; Bronchial Provocation Tests ; Cell Count ; Dithiothreitol ; Eosinophils ; Humans ; Inflammation* ; Inhalation ; Methacholine Chloride ; Neutrophils ; Spirometry ; Sputum*

No abstract available.
Pancytopenia*

Salmonella-triggered reactive arthritis appears one to three weeks after the onset of salmonella infection and presents with asymmetric, usually migratory, oligo- or polyarthritis. The course is usually self-limiting and symptoms last two to six months. We experienced a 10-year-old male patient who presented to a local pediatric center with long-lasting fever and right ankle joint pain. The pain migrated to the left ankle joint, both wrists, and both knees and he was diagnosed as juvenile rheumatoid arthritis and was medicated with NSAIDs and corticosteroid. In the meantime, 20 days prior to the transfer to our hospital he was febrile with nausea and abdominal pain and the antibody titer of S. typhi O Ag by Widal test was 1 : 320, and an antibiotic therapy was followed. Soon after, the fever subsided but the migrating joint symptoms continued and he was transferred to our hospital. Widal tests were weekly checked and the antibody titers of S. typhi O Ag were 1 : 160, 1 : 320, 1 : 320, 1 : 160, 1 : 160, respectively. ESR was 55 mm/hr, CRP 9.18 mg/dl, HLA-B27 positive and his endoscopic findings of the colon showed mild lymphoid hyperplasia and mucosal nodularities in the cecum and ileocecal area. Stool cultures and duodenal juice culture for Salmonella and Shigella were all negative. He was treated with ibuprofen and bactrim and the joint symptoms were gradually mitigated. After discharge, he maintained mildly elevated CRP levels and antibody levels by Widal tests, but was free from symptoms except for several episodes of finger pains for 11 months.
Abdominal Pain ; Ankle Joint ; Anti-Inflammatory Agents, Non-Steroidal ; Arthritis ; Arthritis, Juvenile* ; Arthritis, Reactive* ; Cecum ; Child* ; Colon ; Fever ; Fingers ; HLA-B27 Antigen ; Humans ; Hyperplasia ; Ibuprofen ; Joints ; Knee ; Male ; Nausea ; Salmonella ; Salmonella Infections ; Shigella ; Trimethoprim, Sulfamethoxazole Drug Combination ; Wrist

Interstitial lung disease refers to a group of pulmonary disorders characterized by inflammation of the interstitium, derangements and loss of alveolar capillary units leading to disruption of alveolar gas exchange, which induces symptoms of restrictive lung disease. Cases of interstitial pneumonia in children are uncommon and mostly have unknown causes. We have experienced an 8-year old boy who had symptoms of cyanosis, dry cough, dyspnea and abrupt weight loss. He had not been exposed to organic dusts, allergens or any other systemic disease infections. Chest radiology showed diffuse ground glass opacity in both lung fields. High resolution computed tomography(HRCT) showed multiple small patchy areas of consolidation with an underlying ground glass appearance in both lungs. The pathologic findings of lung biopsy tissue showed patchy areas of interstitial fibrosis, alveolar obliteration and nodular fibrotic areas, strongly suggesting interstitial pneumonia. No specific finding of viral inclusion or any other evidence of infection was found under electromicroscopy. We used peak flow meters to compare functional improvement. Forced expiratory volume in one second (FEV1) was decreased to 25 percent of predicted value. The boy was given treatment with prednisone and showed improvements in HRCT findings after two months. He was able to tolerate easy exercise in school and showed clinical improvements after one year of follow up.
Allergens ; Biopsy ; Capillaries ; Child ; Cough ; Cyanosis ; Dust ; Dyspnea ; Fibrosis ; Follow-Up Studies ; Forced Expiratory Volume ; Glass ; Humans ; Idiopathic Interstitial Pneumonias* ; Inflammation ; Lung ; Lung Diseases ; Lung Diseases, Interstitial ; Male ; Prednisone ; Thorax ; Weight Loss

Mesenchymal hamartoma is an uncommon benign tumor usually found in childhood, especially during the first two years of life. The tumor consists of a solid component and multiple cyst. Without treatment, these lesions can grow to an enormous size. We experienced a case of mesenchymal hamartoma which was found incidentally, in a 8 month old girl who had ascending cholangitis after Kasai operation due to biliary atresia. On abdominal ultrasonography and CT, there was a well-defined homogeneous small echogenic mass in the right lobe of the liver with cirrhosis. Five months later, she underwent liver transplantation. Gross picture of the resected liver showed a dark greenish pigmented solid mass in the right lobe of the cirrhotic liver. Microscopic findings showed reactive mesenchyma and epithelial overgrowth.
Biliary Atresia* ; Cholangitis ; Female ; Fibrosis ; Hamartoma* ; Humans ; Infant ; Liver ; Liver Transplantation ; Mesoderm ; Ultrasonography

A 52-year-old woman suffering from recurrent orogenital ulcerations with superficial candidiasis and chronic mucocutaneous herpes simplex infection was admitted for headache and productive cough. She had undergone a thymectomy due to thymoma of an epithelial cell type several years ago. Radiologic and immunologic examinations revealed bronchiectasis in the left lower lobe, severe deficiency in all isotypes of immunoglobulin and an abnormal delayed hypersensitivity to ubiquitous antigens on skin test. Analysis of lymphocyte subsets in peripheral blood and bone marrow showed marked decreases in the proportion of cells bearing B cell markers. Her symptoms and signs were improved with antibiotics, antifungal and antiviral agents, and monthly administration of high dose intravenous immunoglobulin (IVIG, 400mg/kg). This is a rare case of Good's syndrome presenting, a humoral and cellular immune deficiency syndrome related with thymoma. The pathogenic mechanism of hypogammaglobulinemia in this case might be caused by a block in the early stage of B cell differentiation.
Agammaglobulinemia ; Antifungal Agents ; Antiviral Agents ; Bone Marrow ; Bronchiectasis ; Candidiasis ; Cell Differentiation ; Cough ; Epithelial Cells ; Female ; Headache ; Herpes Simplex ; Humans ; Hypersensitivity, Delayed ; Immunoglobulins ; Lymphocyte Subsets ; Middle Aged ; Skin Tests ; Thymectomy ; Thymoma ; Ulcer