BACKGROUND: Stress has been recognized as a risk factor to various disorders including peptic ulcer disease. Life events are universal which everybody experiences. This study was done to find out whether stressful life events have a role in the development and exacerbation of peptic ulcer disease (PUD) and non-ulcer dyspepsia(NUD) comparing Lee's life stress scale between patients with gastroscopically proven PUD and NUD and those of control. METHODS: On hundred twenty two patients with PUD were studied at our institution from February 1, 1997 to June 30, 1997. Patients who experienced abdominal discomfort and found to have normal or chronic superficial gastritis by gastroscopic exam during the same period were selected for NUD group. Controls were selected from asymptomatic individuals who underwent upper gastrointestinal series procedure for a health screening. Stressful life events investigated were total, positive, and negative stresses measured by Lee's life stress scale(98 items), marital status, level of education, income, occupation, religion, history of cigarette smoking, and the amount of alcoholic consumption and were compared between the three groups. The data were analyzed by one way ANOVA and chi-square test. RESULTS: No statistically significant difference was found in total, positive, and negative stress scores between PUD group and NUD group, although they were significantly higher in PUD and NUD groups than those of the control group(p<0.05). Also statistically significant difference in income and occupation, tests and school, problems associated children and familial conflict were found between PUD group and the control group(p<0.05), as well as between NUD group and the control group(p<0.05). CONCLUSION: Stressful life events were associated with development of PUD and NUD.
Alcoholics ; Child ; Dyspepsia* ; Education ; Gastritis ; Humans ; Marital Status ; Mass Screening ; Occupations ; Peptic Ulcer* ; Risk Factors ; Smoking ; Stress, Psychological ; Ulcer*

Basaloid follicular hamartoma (BFH), uncommon rare benign neoplasm connected to the adnexal structures, presents with multiple clinical manifestations that can develop into basal cell carcinoma. BFH may be congenital or acquired, and the congenital form can be further divided into the generalized and unilateral type, and the acquired form may present as localized and solitary lesions. Congenital, generalized BFH is associated with systemic diseases such as alopecia, cystic fibrosis, hypohidrosis, and myasthenia gravis. In contrast, sporadic cases are observed as unilateral or localized lesions. BFH shows thick cords and thin strands of anastomosing basaloid proliferations that arise from hair follicles and are enclosed by loose fibrous stroma. Here, we report a 70-year-old man with an acquired, solitary form of BFH.
Aged ; Alopecia ; Carcinoma, Basal Cell ; Cystic Fibrosis ; Hair Follicle ; Hamartoma ; Humans ; Hypohidrosis ; Myasthenia Gravis

Nicolau syndrome or embolia cutis medicamentosa is a rare complication of a still largely unidentified pathogenesis at the site of intramuscular injections of various drugs. It is characterized by development of an acute, severe pain around the injection site followed by a localized erythema, a reticular rash, a hemorrhagic patch and varying degrees of tissue damage. The disease outcomes vary from atrophic ulcers and pigmentation to lower limb paralysis and limb amputation. We describe a 34-year-old woman with the diagnosis of this syndrome after she received an intramuscular diclofenac-beta-dimethyl-aminoethanol injection to the lateral aspect of the right upper buttock. The patient was treated by surgical debridement with concomitant primary closure.
Adult ; Amputation ; Buttocks ; Debridement ; Diclofenac ; Erythema ; Exanthema ; Extremities ; Female ; Humans ; Injections, Intramuscular ; Lower Extremity ; Paralysis ; Pigmentation ; Ulcer

Immunoglobulin G4 (IgG4)-related kidney disease is a chronic immune-mediated fibro-inflammatory disorder characterized by multiple organ infiltration with IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis or tumefactive lesions. Previous studies have explored IgG4-related kidney disease, increasing our understanding of its clinical manifestations, and pathological and radiologic findings. However, IgG4-related kidney disease can be misdiagnosed since it mimics malignancies. We report a case of a 77-year-old Korean man diagnosed with IgG4-related kidney disease with membranous proliferative glomerulonephritis, presenting with a renal pelvic mass suspected of being malignant.

Immunoglobulin G4 (IgG4)-related kidney disease is a chronic immune-mediated fibro-inflammatory disorder characterized by multiple organ infiltration with IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis or tumefactive lesions. Previous studies have explored IgG4-related kidney disease, increasing our understanding of its clinical manifestations, and pathological and radiologic findings. However, IgG4-related kidney disease can be misdiagnosed since it mimics malignancies. We report a case of a 77-year-old Korean man diagnosed with IgG4-related kidney disease with membranous proliferative glomerulonephritis, presenting with a renal pelvic mass suspected of being malignant.

To investigate the toxic effects of cheonggukjang (CKJ) manufactured using mixed cultures of Bacillus subtilis MC31 and Lactobacillus sakei 383 on the liver and kidney of ICR mice, an alteration on the related markers including body weight, organ weight, urine composition, liver pathology and kidney pathology were analyzed after oral administration at dosage of 25, 50 and 100 mg/kg body weight/day of CKJ for 14 days. Any significant toxicity was not observed on the body and organ weight, clinical phenotypes, urine parameters and mortality in the CKJ-treated group compared with the vehicle-treated group. Also, liver toxicity analysis revealed no significant increase in alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) or lactate dehydrogenase (LDH) in response to CKJ. Additionally, the specific pathological features induced by most toxic compounds were not observed upon liver histological analysis. Furthermore, kidney toxicological analysis revealed that blood urea nitrogen (BUN) and the serum creatinine (Cr) levels and pathological features on histological sections did not differ significantly between the vehicle- and CKJ-treated groups. Overall, these results suggest that CKJ does not induce any specific toxicity in liver and kidney organs of ICR at dose of 100 mg/kg body weight/day as no observed adverse effect level (NOAEL).
Administration, Oral ; Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Bacillus subtilis* ; Blood Urea Nitrogen ; Body Weight ; Creatinine ; Kidney* ; L-Lactate Dehydrogenase ; Lactobacillus* ; Liver* ; Mice ; Mice, Inbred ICR* ; Mortality ; No-Observed-Adverse-Effect Level ; Organ Size ; Pathology ; Phenotype ; Soybeans*

Red Liriope platyphylla (RLP) has been manufactured from Liriope platyphylla (L. platyphylla, LP) roots using steaming process and investigated as a curative agent for treatment of diabetes, obesity and neurodegenerative disorders. To examine the precautionary effects of aqueous extract RLP (AEtRLP) on the preclinical stages of Alzheimer's Disease (AD), alterations of the key factors influencing AD were investigated in Tg2576 mice after AEtRLP7 treatment for 4 months. Abeta-42 peptides level was significantly decreased in the brain of AEtRLP7-treated Tg2576 mice compared to vehicle-treated Tg2576 mice, although significant differences on improving behavioral defects were not observed in the same group. The concentration of nerve growth factor (NGF) in serum was also higher in AEtRLP7-treated Tg2576 mice than vehicle-treated Tg2576 mice. However, the phosphorylation of TrkA and Erk among the downstream effectors of the high affinity NGF receptor was significantly lower in AEtRLP7-treated Tg2576 mice. A similar pattern was observed in the expression level of downstream effectors within low affinity NGF receptor. Overall, these results suggest that AEtRLP7 can contribute to preventing the production and deposition of Abeta-42 peptides during the early progression stage of AD in the brain of Tg2576 mice through increased NGF secretion.
Alzheimer Disease* ; Animals ; Brain ; Mice* ; Nerve Growth Factor* ; Neurodegenerative Diseases ; Obesity ; Peptides ; Phosphorylation ; Receptor, Nerve Growth Factor ; Steam

In order to investigate the effects of a fermented soybean product (Chungkookjang, CKJ) on nerve growth factor (NGF) metabolism, NGF secretion ability and its related signaling pathway were analyzed in B35 neuronal cells and the Tg2576 mouse model of Alzheimer's disease (AD). In B35 cells, the concentration of NGF significantly increased upon treatment with Taegwang (TG)-CKJ and Shinhwa (SH)-CKJ extracts compared with vehicle. Further, a significant increase in PC12 cell length as well as the phsophorylation levels of TrkA and Akt, which are members of a high affinity NGF receptor signaling pathway, were observed after treatment with TG-CKJ and SH-CKJ conditional medium (CM). On the other hand, there was no difference in activation of the NGF receptor p75NTR signaling pathway between vehicle and all CKJ treated groups. In Tg2576 mice showing early stage of AD, the concentrations of NGF in the serum and brain were reduced compared with those in Non-Tg mice. Treatment of Tg2576 mice with SH-CKJ, which contains high concentrations of total flavonoids and phenolic compounds, for 8 weeks dramatically recovered the NGF level to that of Non-Tg mice. Furthermore, the low phosphorylation levels of TrkA and Erk in the NGF receptor TrkA signaling pathway were rapidly recovered to those of Non-Tg mice after SH-CKJ treatment in vehicle treated Tg2576 mice, whereas the phosphorylation level of Akt was maintained at a constant level. These results suggest that CKJ may stimulate NGF secretion ability as well as the NGF receptor TrkA signaling pathway in PC12 cells and Tg2576 mice.
Alzheimer Disease ; Animals ; Brain ; Flavonoids ; Hand ; Isoflavones ; Mice ; Nerve Growth Factor ; Neurons ; PC12 Cells ; Phenol ; Phosphorylation ; Receptor, Nerve Growth Factor ; Soybean Proteins ; Soybeans

Obesity hypoventilation syndrome (OHS) is characterized by severe obesity, excessive daytime sleepiness, hypoxemia and hypercapnea. Because OHS mimics pulmonary hypertension or cor pulmonale, clinicians should recognize and treat this syndrome appropriately. A 58-year-old female visited the emergency room because of dyspnea. She was obese and had kyphoscoliosis. The patient also experienced snoring, recurrent choking during sleep and daytime hypersomnolence which worsened after gaining weight in the recent year. The arterial blood gas analysis showed she experienced hypoxemia and hypercapnea not only during nighttime but also daytime. We suspected OHS and the patient underwent polysomnography to confirm whether obstructive sleep apnea was present. During the polysomnography test, sleep obstructive apnea was observed and apnea-hypopnea index was 9.2/hr. The patient was treated with bilevel positive airway pressure therapy (BiPAP). After BiPAP for 4 days, hypoxemia and hypercapnia were resolved and she is currently well without BiPAP. We report a case successfully treated with clinical improvement by presuming OHS early in a patient who had typical OHS symptoms, even while having other conditions which could cause hypoventilation.
Airway Obstruction ; Anoxia ; Apnea ; Blood Gas Analysis ; Disorders of Excessive Somnolence ; Dyspnea ; Emergency Service, Hospital ; Female ; Humans ; Hypercapnia ; Hypertension, Pulmonary ; Hypoventilation ; Middle Aged ; Obesity Hypoventilation Syndrome* ; Obesity, Morbid ; Polysomnography ; Pulmonary Heart Disease ; Sleep Apnea, Obstructive ; Snoring

Background/Aims: Receptor tyrosine kinase-like orphan receptor 2 (ROR2) is a major regulator of Wnt signaling, which is involved in fibroblast dysfunction. Because its role has not been evaluated in idiopathic pulmonary fibrosis (IPF), we examined the clinical implications of ROR2 expression. Methods: ROR2 mRNA expression was measured using reverse transcription polymerase chain reaction in lung tissue-derived fibroblasts from IPF patients (n = 14) and from controls (n = 10). ROR2 protein was measured using enzyme-linked immunosorbent assay in primary fibroblasts from IPF patients (n = 14) and controls (n = 10), and in bronchoalveolar lavage (BAL) fluids obtained from normal controls (NC; n = 30). IPF patients (n = 84), and other patients with interstitial lung diseases, including nonspecific interstitial pneumonia (NSIP; n = 10), hypersensitivity pneumonitis (HP; n = 10), and sarcoidosis (n = 10). Results: ROR2 mRNA and protein levels were significantly higher in IPF fibroblasts than in controls (p = 0.003, p = 0.0017, respectively). ROR2 protein levels in BAL fluids from patients with IPF were significantly higher than in those from NC (p < 0.001), and from patients with NSIP (p = 0.006), HP (p = 0.004), or sarcoidosis (p = 0.004). Receiver operating characteristic curves showed a clear difference between IPF and NC in ROR2 protein level (area under the curve, 0.890; confidence interval, 0.829 to 0.950; p < 0.001). ROR2 protein levels were significantly higher in GAP stage III than in GAP stages I and II (p = 0.016). Conclusions ROR2 may be related to the development of IPF, and its protein level may be a useful and severity-dependent candidate marker for IPF.