BACKGROUND: IL-8 is a potent chemotactic cytokine that plays an important role in the host defense mechanism against M. tuberculosis by recruiting inflammatory cells to the site of the infection. Lung epithelial cells, as well as alveolar macrophages are known to preduce IL-8 in response to M. tuberculosis. IL-8 gene expression is mainly regulated on the level of transcription by NF-κB. This study investigated whether or not A549 cells produce IL-8 in NF-κB dependent mechanism in response to macrophages phagocytosing M. tubersulosis. METHODS: Peripheral blood monocytes that were obtained from healthy donors were cultured for 24 h with M. tuberculosis and a conditioned medium(CoMTB) was obtained. As a negative control, the conditioned medium without M. tuberculosis (CoMCont) was used. A549 cells were stimulated with M. tuberculosis, CoMCont and CoMTB and the IL-8 concentration in the culture media was measured by ELISA. The CoMTB induced IL-8 mRNA expression in the A549 cells was evaluated using RT-PCR, and CoMTB induced IκBα degradation was measured using western blot analysis. CoMTB induced nuclear translocation and DNA binding of NF-κB was also examined using an electrophoretic mobility shift assay(EMSA), and the CoMTB induced NF-κB dependent IL-8 transcriptional activity was measured using a luciferase reporter gene assay. RESULTS: CoMTB induced IL-8 production by A549 cells(46.8±4.8 ng/ml) was higher than with direct stimulation with M. tuberculosis (6.8±2.9 ng/ml). CoMTB induced IL-8 mRNA expression increased after 2 h of stimulation and was sustained for 24 h. IκBα was degraded after 10 min of CoMTB stimulation and reappeared by 60 min. CoMTB stimulated the nuclear translocation and DNA binding of NF-κB. The CoMTB induced NF-κB dependent IL-8 transcriptional activity(13.6±4.3 times control) was higher than either CoMCont(2.0±0.6 times control) or M. tuberculosis (1.4±0.6 times control). CONCLUSION: A conditioned medium of peripheral blood monocytes phagocytosing M. tuberculosis stimulates NF-κB dependent IL-8 production by the lung epithelial cells.
Blotting, Western ; Culture Media ; Culture Media, Conditioned ; DNA ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression ; Genes, Reporter ; Humans ; Interleukin-8* ; Luciferases ; Lung* ; Macrophages ; Macrophages, Alveolar ; Monocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; Tissue Donors ; Tuberculosis

Vertigo mimicking labyrinthine lesions may have resulted from ischemic insult to the inner ear or the vestibular nerve and nucleus in the AICA infarction syndrome. A 56-year-old female was admitted to the emergency room with vertigo and hearing loss in right ear. On neurological examination, she had left beating jerky torsional and horizontal nystagmus with falling and past pointing to right side. Brain magnetic resonance images showed high signal intensity in anterolateral portion of inferior pons on T2- weighted images. Severe right facial palsy of peripheral type developed 24 hours after admission. Audiometry and electronystagmography documented absent auditory and vestibular function on the affected side. We argue that vertigo of the acute infarction in AICA territory can be involved the eight and seventh nerve root entry zoon and mimic labyrinthine lesions
Audiometry ; Brain ; Ear ; Ear, Inner ; Electronystagmography ; Emergency Service, Hospital ; Facial Nerve* ; Facial Paralysis ; Female ; Hearing Loss ; Humans ; Infarction* ; Middle Aged ; Neurologic Examination ; Nystagmus, Pathologic ; Pons ; Vertigo* ; Vestibular Nerve

Background: Spontaneous pneumopericardium is a very rare condition. Spontaneous pneumothorax and pneumomediastinum have been reported to be associated with an idiopathic pulmonary fibrosis (IPF). However, spontaneous pneumopericardium has not yet been reported in association with IPF. Here we report a case of spontaneous pneumomediastinum and pneumopericardium in a patient with acute exacerbation of IPF with a review of the relevant literature.
Humans ; Idiopathic Pulmonary Fibrosis* ; Mediastinal Emphysema* ; Pneumopericardium* ; Pneumothorax

Nucleolar organizer regions(NORs) are intranucleolar segments of DNA coding for ribosomal RNA and contribute to the regulation of cellular protein synthesis. Since NOR-associated proteins are argyrophilic, silver staining method has been used for demonstration of NORs. The numbers of argyrophilic NORs(AgNORs) have been shown to be correlated with DNA ploidy and have prognostic value in diverse human neoplasms. However, the prognostic value of AgNORs in renal cell carcinoma(RCC) remain ill defined. We herein investigated the prognostic value of AgNORs in 39 patients with RCC. There was no significant relationship between mean number of AgNORs (m AgNORs) per nucleus and Robson stage and Fuhrman nunlear grade. However, there was significant relationship between the percentage of tumor cells with more than five AgNORs per nucleus (p AgNORs) and Robson stage and nuclear grade (p<0.05). There was significant difference in survival rate between patients with RCC in whom AgNORs were two or less and in whom AgNORs were greater than two(p<0.05). The patients with a low p AgNORs(less than 8%) have a better prognosis than those with a high p AgNORs. These results suggest that number of AgNORs may be a clinically useful prognostic marker for patients with RCC.
Carcinoma, Renal Cell* ; Clinical Coding ; DNA ; Humans ; Nucleolus Organizer Region* ; Ploidies ; Prognosis ; RNA, Ribosomal ; Silver Staining ; Survival Rate

PURPOSE: Our examination was designed to determine the diagnostic properties of the cutoff point for the prediction of bacteremia in febrile children less than 3 years of age. Cutoff point is the value that simultaneously maximizes both sensitivity and specificity. METHODS: We conducted a retrospective study of febrile children, less than 3 years of age, who clinically have no identifiable source of fever. Peripheral blood leukocyte count(WBC), absolute neutrophil count(ANC), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were measured at the same time. All patients received blood culture, urine culture and/or CSF culture. Bacterial infection was defined as single pathogen isolated from the CSF or blood or a urinary tract infection (UTI). Patients were dichotomized into two groups: those with bacterial infection and no bacterial infection. We analyzed the characteristics of the children in the two groups. RESULTS: Seventy-one patients(44 males; 27 females) were enrolled in the study. Twenty patients (28%) had a serious bacterial infection(twelve urinary tract infection, five bacteremia, three meningitis) and fifty-one(72%) had no serious bacterial infection. WBC, ESR and CRP were significantly different between the two groups(P<0.05). The cutoff point of WBC, ESR and CRP were 20,000/mm3, 30 mm/hr and 3.0 mg/dL, respectively. The sensitivity and specificity of each cutoff point were WBC(75%, 75%), ESR(79%, 68%) and CRP(83%, 77%), respectively. CONCLUSION: These data show the ability of predictors to identify febrile children less than 3 years of age with bacterial infection. Febrile children who reach the cutoff point must be treated intensively and those who do not reach the cutoff point can be carefully managed without administering antimicrobial agents.
Anti-Infective Agents ; Bacteremia ; Bacterial Infections* ; Blood Sedimentation ; Child* ; Fever ; Humans ; Leukocytes ; Male ; Neutrophils ; Retrospective Studies ; Sensitivity and Specificity ; Urinary Tract Infections

BACKGROUND: The correlation between the high resolution computed tomography(HRCT) emphysema score and the physiologic parameters including resting and exercise pulmonary function test was investingated in 14 patients(60.6±10.3 years) with pulmonary emphysema. METHODS: The patients underwent a HRCT, a resting pulmonary function test, and incremental exercise testing(cycle ergometer, 10 W/min). Computed tomography scans were obtained on a GE highlight at 10 mm intervals using 10 mm collimation, from the apex to the base after a full inspiration. The emphysema scores wer determined by a CT program 'Density mask' outlining the areas with attenuation values less than -900 HU, indicating the emphysema areas, and providing an overall percentage of lung involvement by emphysema. RESULTS: Among the resing PFT parameters, only the diffusing capacity(r=-0.75) and PaO2 (r=-0.66) correlated with the emphysema score(p<0.05). Among the exercise test parameers, the emphysema score correlated significantly with the maximum power(r=-0.74), maximum oxygen consumption(r=-0.68), anaerobic threshold(V-slope method : r=-0.69), maximal O2-pulse(r=-0.73), and the physiologic dead space ratio at the maximum workload(r=-0.80)(p<0.01). CONCLUSION: We could find that exercise testing parameters showed a much better correlation with the HRCT emphysema score, which is known to have a good correlation with the pathologic severity than the resting PFT parameters. Therefore it is suggested that exercise testing is superior to resting PFT for estimating in the estimation of the physiologic disturbance in emphysema patients.
Emphysema* ; Exercise Test ; Humans ; Lung ; Oxygen ; Pulmonary Emphysema ; Respiratory Function Tests

PURPOSE: Pleural effusions may develop during the course of bacterial pneumonia. The aim of this study was to evaluate the significance of the polymerase chain reaction (PCR) method for detection of Mycoplasma pneumoniae, Mycobaterium tuberculosis and Staphylococcus aureus from pleural fluid. METHODS: Total 12 samples were obtained from pleural fluid; 2 samples from children with Mycoplasma pneumonia, 5 samples from adults with tuberculous pleurisy, and 5 samples from sterile pleural fluid seeded artificially with staphylococcus aureus. The primers used for our PCR were prepared to amplify M. pneumonia-specific MP5 gene, M. tuberculosis-specific IS6110 gene, and S. aurus-specific femA and mecA gene. The amplified PCR products were detected by ethidium bromide-stained agarose gel electrophoresis. RESULTS: A total of 12 pleural fluid samples were tested by nested PCR using the specific primer set. We could amplify MP5 gene in 2 samples, IS6110 gene in 5 samples, mecA gene in 3 samples, and femA gene in 5 samples. These PCR data were correlated with serolological data, microbiological data and methicillin-sensitivity test result. There were no false-positive results due to cross-contaminating DNA between these 3 organisms. CONCLUSIONS: We conclude that enzymatic amplification of specific gene from pleural fluid might be useful to diagnose the infectious pleural effusion by Mycoplasma pneumoniae, Mycobacterum tuberculosis or Staphylococcus aureus.
Adult ; Child ; DNA ; Electrophoresis, Agar Gel ; Ethidium ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pleural Effusion ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction* ; Staphylococcus aureus* ; Staphylococcus* ; Tuberculosis ; Tuberculosis, Pleural

Emphysema is characterized by air space enlarge?ment and alveolar destruction. The mechanism responsible for the development of emphysema was thought to be protease/antiprotease imbalance and oxidative stress. A very recent study shows that alveolar cell apoptosis causes lung destruction and emphysematous changes. Thus, this study was per?formed to support the evidence for the role of apoptosis in the development of emphysema by characterizing cigarette smoke extract (CSE)-induced apoptosis in A549 (type II pneumocyte) lung epithelial cells. CSE induced apoptosis at low concentration (10% or less) and both apoptosis and necrosis at high concentration (20%). Apoptosis was demonstrated by DNA fragmentation using FACScan for subG1 fraction. Discrimination between apoptosis and necrosis was done by morphologic analysis using fluorescent microscopy with Hoecst 33342/propium iodide double staing and electron microscopy. Cy?tochrome c release was confirmed by using immuno?fluorescence with monoclonal anti-cytochrome c antibody. However, CSE-induced cell death did not show the activation of caspase 3 and was not blocked by caspase inhibitors. This suggests that CSE-induced apoptosis might be caspase-independent apoptosis. CSE-induced cell death was near com?pletely blocked by N-acetylcystein and bcl-2 over?expression protected CSE-induced cell death. This results suggests that CSE might induce apoptosis through intracellular oxidative stress. CSE also activated p53 and functional knock-out of p53 using stable overexpression of HPV-E6 protein inhibited CSE-induced cell death. The characterization of CSE-induced cell death in lung epithelial cells could support the role of lung cell apoptosis in the patho?genesis of emphysema.
Apoptosis ; Caspase 3 ; Caspase Inhibitors ; Cell Death* ; Discrimination (Psychology) ; DNA Fragmentation ; Emphysema ; Epithelial Cells* ; Lung* ; Microscopy ; Microscopy, Electron ; Necrosis ; Oxidative Stress ; Smoke* ; Tobacco Products*

BACKGROUND: The precise measurement of body temperature during anesthesia is important to prevent hypothermia.The aim of this study was to compare the urinary bladder temperature to the esophageal, nasopharyngeal, rectal and skin temperatures, and to compare three heating methods during spine surgery. METHODS: Forty-two patients with ASA physical status I-II, who were scheduled to undergo spine surgery in the prone position, were included in this study.The patients were randomly divided into 4 groups:Group I was treated without any heating methods; group 2, with fluid-warmers; group 3, with forced air-warmers; and group 4, with a combination of both heating methods.After the induction of anesthesia, the esophageal, nasopharyngeal, rectal, urinary bladder and skin temperature was monitored every 15 minute for 3 hours.The urinary bladder temperature was compared to the esophageal, nasopharyngeal, rectal and skin temperatures. RESULTS: The urinary bladder temperature was found to be higher than the esophageal and the nasopharyngeal temperatures (P < 0.01).The urinary bladder temperature of group 3 was higher than that of group 1 at 180 minutes after induction of anesthesia (P < 0.05).The urinary bladder temperature of group 4 was higher than that of group 1 at 150 minutes (P < 0.05), as well as at 165 and 180 minutes (P < 0.05).The skin temperatures of groups 3 and 4 were higher than group 1 (P < 0.001). CONCLUSIONS: The urinary bladder temperature was higher than the esophageal temperature and correlated with the esophageal, nasopharyngeal and rectal temperatures.During spine surgery in the prone position, a forced air-warmer was found to be the most effective but a combination of all the methods tested was found to be even more effective.
Anesthesia ; Body Temperature ; Heating ; Hot Temperature ; Humans ; Prone Position ; Skin ; Skin Temperature ; Spine ; Urinary Bladder

BACKGROUND: Defects in apoptotic signaling pathways play important role in tumor initiation, progression, metastasis and resistance to treatment. Several proteins which may promote tumorigenesis by inhibiting apoptosis were identified. The survivin protein is the member of inhibitor of apoptosis protein(IAPs) family which inhibits apoptosis. Unlike other IAPs, it is expressed in during the fetal period but not in adult differentiated tissues. Many reports have stated that survivin is selectively expressed in many cancer cell lines and cancer tissues. We performed immunohistochemical analysis for survivin expression in non-small cell lung cancer to get evaluate its clinical implication. METHODS: Twenty nine surgically resected lung cancers were examined. Immunohistochemical staining were performed by immuno-peroxidase technique using avidin-biotinylated horseradish peroxidase complex in the formalin-fixed, paraffin-embedded tissue 4 µm section. Anti-survivin polyclonal antibody was used for primary antibody and anti-p53 monoclonal antibody was also used to analyze the correlation between survivin and p53 expression. The survivin expression scores were determined by as the sum of the stained area and intensity. RESULTS: Immunohistochemical analysis showed cancer specific expression of survivin in 20 of 29 cases (69.0%). Western blot analysis also showed the selective survivin expression in turmor tissue. There was no correlation between survivin expression and clinicopathological parameters and prognosis. We analyzed the correlated between survivin expression and p53 expression, but found none. CONCLUSION: We confirmed the tumor specific expression of survivin in non-small cell lung cancer But this pression was not correlated with clinical parameters as well as histlogy, tumor stage recurrence, and sur rate. Also it ws not statistically correlated with the expression of p53.
Adult ; Apoptosis ; Blotting, Western ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung* ; Cell Line ; Horseradish Peroxidase ; Humans ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins* ; Lung Neoplasms ; Neoplasm Metastasis ; Prognosis ; Recurrence