No abstract available.
Polymerase Chain Reaction*

Extrahepatic metastasis of Hepatocellular carcinoma(HCC) to the gastrointestinal tract is uncommon. Because most of metastases to the gastrointestinal tract have no clinical manifestations, they are usually found incidentally at the time of an autopsy or a laparotomy, We experienced a case of duodenal metastasis of HCC, which presented UGI bleeding. A 59 years old male was admitted to our hospital due to generalized jaundice, which lasted for about a week. From the third day of admission, he had episodes of hematemesis and melena. An abdoinal CT scan demonstrated multiple, variable sized low-density masses in the entire liver with portal vein thrombosis and conglomerated lymph nodes. An esophagogastroduodenoscopy showed a protruded submucosal mass-like lesion with multiple ulceration in the duodenal bulb. We confirmed the duodenal mass-like lesion to be hepatocellular carcinoma by a biopsy and a histoimmunochemical study.
Autopsy ; Biopsy ; Carcinoma, Hepatocellular* ; Endoscopy, Digestive System ; Gastrointestinal Tract ; Hematemesis ; Hemorrhage* ; Humans ; Jaundice ; Laparotomy ; Liver ; Lymph Nodes ; Male ; Melena ; Middle Aged ; Neoplasm Metastasis* ; Tomography, X-Ray Computed ; Ulcer ; Venous Thrombosis

Background: Chronic use of glucocorticoid is known to result in osteoporosis. Deflazacort (DFZ), a synthetic glucocorticoid, has been reported to have bone sparing properties in vivo eompared to dexamethasone(DEX). Not only the direct effect of DFZ on human osteoblast but the mechanism by which the drug spares bone remains unclear. This study, therefore, is aimed to investigate the direct effect of DFZ on the proliferation and differentiation of human osteoblast as well as on the gene expression of osteocalcin and osteoblast as well as on the gene expression of osteocalcin and growth factor produced in osteoblast. Methods: Human osteoblast-like cells were cultured from a piece of the tibia removed during selective orthopedic surgery for patients without metabolic bone diseases. The morphological iden- tification of osteoblast-like cell was performed under the light microscope after alkaline phosphatase staining. Cell proliferation rate was determined by [3H] thymidine incorporation into DNA. Cell differentiation was determined by alkaline phophatase activity. mRNA expression was quanti- tatively measured by the competitive reverse transcription-polymerase ehain reaction(RT-PCR). Results: The cultured cells demonstrated 1,25-dihydroxyvitamin D3-induced increases in alkaline phophatase activity and osteocalcin mRNA expression which are the properties of osteoblast. Twenty six percent of the cultured cells were identified as osteoblast-like cells by alkaline phophatase staining. After 24hr incubation with DEX or DFZ, the [3H) thymidine incorporation was significantly inhibited by 100nM DEX or DFL Alkaine phophatase activity was significantly increased by 100nM DEX. Osteocalcin mRNA was significantly decreased by both glueocorticoids. While DEX significantly suppressed expression of asteocalcin mRNA at 10nM and 100nM, DFZ did so only at 100nM. IGF-I mRNA was significantly decreased by 100nM DEX. Conclusion: These results suggest that the inhibitory effect of DFZ on the cell proliferation and protein synthesis is less than that of DEX, which might be responsible for the bone sparing effect of DFZ in vivo.
Alkaline Phosphatase ; Bone Diseases, Metabolic ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Dexamethasone ; DNA ; Gene Expression ; Humans ; Insulin-Like Growth Factor I ; Orthopedics ; Osteoblasts ; Osteocalcin ; Osteoporosis ; RNA, Messenger ; Thymidine ; Tibia

We tested the hypothesis that angiotensin-converting enzyme (ACE) and angiotensinogen gene polymorphism influence the incidence, development and outcome of preeclampsia. Subjects were recruited from 90 Korean patients with preeclampsia during pregnancy and 98 age-matched controls. After isolation of DNA, polymerase chain reactions (PCR) were carried out to detect polymorphism of the ACE and angiotensinogen. M235T and T174M genotypes of angiotensinogen were determined by digestion with restriction enzyme endonuclease Tth 111-I and NCo I, respectively. The frequency of DD genotype was significantly greater in preeclampsia (0.36) than in controls (0.14) (p<0.05). The frequency of D allele was 0.55 in preeclampsia and 0.40 in controls (p<0.05). There were no differences in the onset of preeclampsia and pregnancy outcomes according to the ACE genotypes. There was no difference in the frequency of a allele of angiotensinogen M235T between the groups (0.79:0.78 in preeclampsia : controls). The frequency of T allele of angiotensinogen T174M gene was slightly increased, but not significantly, in preeclampsia (0.11) than in controls (0.07). In a multivariate analysis, only ACE genotype was associated with the development of preeclampsia (beta=0.27, p=0.05). In conclusion, a molecular variant of ACE, but not angiotensinogen, gene is associated with preeclampsia in Korean women.
Adult ; Angiotensinogen/*genetics ; Female ; Gene Frequency ; Genotype ; Human ; Korea ; Peptidyl-Dipeptidase A/*genetics ; *Polymorphism (Genetics) ; Pre-Eclampsia/*genetics ; Pregnancy

Emphysematous cholecystitis is an uncommon form of acute cholecystitis characterized by the presence of gas within the wall, lumen of the gall bladder or biliary ducts. Clinically it is very similar to ordinary farm. But since the risk of perforation is five times that expected from ordinary cholecystitis, early diagnosis and appropriate surgical treatment are important. We could diagnose these cases by the simple abdomen, abdominal ultrasound and abdominal CT by the presence of air in the lumen and the wall of the gall bladder. Percutaneous trans hepatic gall bladder drainage (PTGBD) for decompression was used because poor general condition of patients and later, we could successfully perform the cholecystectomy without any complication. We presented two cases of emphysematous cholecystitis with review of the relevant literature on the subject.
Abdomen ; Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Decompression ; Drainage ; Early Diagnosis ; Emphysematous Cholecystitis* ; Humans ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder

OBJECTIVES: Ulcerative colitis is a chronic inflammatory disease of colon, which is common in western countries but rare in Korea. But the detection rate has been increasing in our hospital recently. The purpose of this study is to review the clinical features and trends of newly diagnosed cases in Korea each year. METHODS: We reviewed 126 cases, of which medical records were available and diagnosed by clinical finding, laboratory examinations, barium enema or colonoscopic examination, histologic and microbial tests at the hospitals in Pusan from Jan. 1986 to Dec. 1995. RESULTS: Recently, newly diagnosed cases tend to increase each year and the peak incidence of age groups was the fourth decade(27.4%) and the male to female ratio was 1:1.07. The common symptomes were hematochezia, diarrhea, abdominal pain, loss of weight, in the order of frequency. The laboratory findings were non-specific, including positive occult blood, increased erythrocyte sedimentation rate, anemia, hypoalbuminemia, and abnormal liver function test. According to the severity of disease, these was 50.8% in mild, 30.6% in moderate and 18.6% in severe disease. The difference of severity according to the extent of disease was not found. According to the extent of disease, these was 23.8% in proctitis, 25.4% in distal, 23.8% in left and 25.4% in extensive colitis. The incidence of proctitis was not more increased after 1991, compared with the previous records. 119 cases were treated medically and most cases showed exellent sort-term response(95.7%). According to the severity, the symptomatic remission rates of milder disease were significantly higher. Surgical treatment was performed in 4 cases(5 times); its indications were perforation in 2 cases, bleeding in 2 cases, and one case had failed to medical treatment. CONCLUSION: These results suggest that the trends of newly diagnosed cases each year have been increased recently. To evaluate the statistically significant clinical features, progress of disease and prognosis of ulcerative colitis in Korea, the nationwide collection of data is necessary.
Abdominal Pain ; Anemia ; Barium ; Blood Sedimentation ; Busan ; Colitis ; Colitis, Ulcerative* ; Colon ; Diarrhea ; Enema ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Hypoalbuminemia ; Incidence ; Korea ; Liver Function Tests ; Male ; Medical Records ; Occult Blood ; Proctitis ; Prognosis ; Ulcer*

Gastric polyps are uncommon. The incidence of gastric polyps has been reported between 0.4% and 2.0%. Two histologically distinct forms of gastric polyps are hyperplastic polyps and adenomatous polyps. Hyperplastic polyps are multiple in up to a half of cases. When the polyps number is more than 50, the term "Hyperplastic polyposis" is applied and such cases are even more rare. Polypoid lesions of the stomach have heen reported in many of the polyposis syndromes, such as Familial polyposis coli, Gardners syndrome, Peutz-Jeghers syndrame, Juvenile polyposis and Cowdens disease. Only 1 case of gastric hyperplastic polyposis associated with colonic hyperplastic polyposis has been reported. The patient under study is not included in any polyposis syndrome and has no familial tendency, We report a case of gastric hyperplastic polyposis with colonic hyperplastic polyposis with literatures reviews.
Adenomatous Polyposis Coli ; Adenomatous Polyps ; Colon* ; Gardner Syndrome ; Hamartoma Syndrome, Multiple ; Humans ; Incidence ; Polyps ; Stomach

BACKGROUND: Osteoprotegerin(OPG) is a soluble member of the tumor necrosis factor(TNF) receptor family and inhibits osteoclastogenesis by interrupting the cell-to-cell interaction between osteoblastic/stromal cells and osteoclast progenitors. OPG is expressed in many tissues including osteoblasts and may act on bone tissues in a paracrine and/or autocrine fashion. Futhermore, many cytokines and growth factors are known to influence the regulation of OPG expression in osteoblastic/stromal cells. The aims of the present study were to examine whether or not OPG was expressed in human peripheral blood mononuclear cells(PBMCs) and to investigate the effects of IL-1beta, which were known as potent osteotropic agents, on the regulation of OPG mRNA in PBMCs. METHODS: PBMCs were isolated by centrifugation over Ficoll-Hypaque density gradients from postmenopausal women and cultured in 6-well plates containing alpha-MEM supplemented with 5% FBS. The expression of OPG mRNA in PBMCs was observed by RT-PCR in adherent and nonadherent cells on culture plates. To observe the effect of OPG expression by IL-1beta, we measured the concentration of OPG mRNA by altering the concentration and incubation time of IL-1beta. The measurement of OPG mRNA was done by semi-quantitative PCR and indicated as OPG/GAPDH. RESULTS: OPG was expressed both in cells attached to the surface of culture plates and in non-adherent cells for the incubation of peripheral blood mononuclear cells. The effect of OPG mRNA by IL-1beta tend to increase in accordance with the length of incubation time and maximizes at 12 hours of incubation time and shows 1.2-3.5 times higher than the standard level at the concentration of 0.5ng/ml. However, the increased quantity in concentration varies according to individuals.] CONCLUSION: OPG mRNA is expressed in peripheral blood mononuclear cells and known to be increased by IL-1beta.
Bone and Bones ; Cell Communication ; Centrifugation ; Cytokines ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; Necrosis ; Osteoblasts ; Osteoclasts ; Osteoprotegerin ; Polymerase Chain Reaction ; RNA, Messenger*

McCune-Albright syndrome (MAS) is a sporadic disease classically including polyostotic fibrous dysplasia, cafe -au-lait spots, sexual precocity, and other hyperfunctional endocrinopathies. Recent investigations suggest an etiological role for activating embryonic somatic missense mutations in the gene for the a subunit of Gs (Gsa), the G protein that stimulates adenylyl cyclase. DNA from bone, ovary, and blood was analyzed by using polymerase chain reaction and sequenced. A embryological somatic mutation of Gsa gene encoding substitution of a Cys for Arg at amino acid 201 from cells of dysplastic bone and ovary was observed, and the distribution of mutant gene reveals mosaic pattern. We report a case of McCune-Albright syndrome with an activating mutation at codon 201 of Gsa subunit on ovary and bone tissue that was experienced recently.
Adenylyl Cyclases ; Bone and Bones ; Codon ; DNA ; Female ; Fibrous Dysplasia, Polyostotic* ; GTP-Binding Proteins* ; Mutation, Missense ; Ovary ; Polymerase Chain Reaction

The human transforming growth factor-3 (TGF-3) is an important cytokine to maintain bone mass by inhibiting osteoclast differentiation. Recently raloxifene response element (RRE), a new enhancer with a polypurine sequence for estrogen receptor (ER)-mediated gene activation, was identified on the TGF-3 gene. Functional analysis of the RRE-mediated pathway has shown that this would be an important pathway for bone preserving effect. We found a novel mutation in the RRE sequence by single-strand conformational polymorphism analysis in one of 200 Korean women. Cloning and sequencing revealed a heterozygote in which one allele had an insertion of 20 nucleotides (AGAGAGGGAGAGGGAGA GGG) between nucleotide +71 and +72 and a point mutation at nucleotide +75 (G-A transition), and the other allele had normal sequence. The insertion was a nearly perfect tandem duplication of the wild type DNA sequence. The bone mineral density of the affected woman was not much lower than that of age-matched controls. Transient transfection of the mutant allele showed no significantly different activity compared with that of the wild type allele. These observations suggest that the heterozygote variation of the RRE sequence seems not to be operative in determination of bone mass.
Estrogen Antagonists/*pharmacology ; Female ; Human ; Middle Age ; *Mutation ; Raloxifene/*pharmacology ; *Response Elements ; Transfection ; Transforming Growth Factor beta/*genetics