BACKGROUND: Adipose tissues were initially introduced as energy storages, but recently they have become famous as an endocrine organ which produces and secretes various kinds of molecules to make physiologic and metabolic changes in human body. It has been studied that these molecules are secreted in abundance as the adipose tissue becomes bigger along with obesity. Furthermore, it has been found that they are mediating systemic inflammation and generation of metabolic diseases such as type 2 diabetes and atherosclerosis. On the basis of these, we studied previous papers which have been researched about the interaction between preadipocytes and macrophages, adipose tissues and lymph nodes, and adipose tissue secreting molecules. RESULTS: Firstly, preadipocytes and macrophages are expressing similar transcriptomes and proteins, and preadipocytes can be converted to mature macrophages which have phagocytic activity. Moreover, the monocytes, which initially located in the bone marrow, are filtrated to the adipose tissue by monocyte chemotatic protein-1 and are matured to macrophages by colony stimulating factor-1. Secondly, adipose tissues and their associated lymph nodes are interacting each other in terms of energy efficiency. Lymph nodes promote lipolysis in adipose tissues, and polyunsaturated fatty acids in adipocytes become energy sources for dendritic cells. Lastly, adipose tissues produce and secrete proinflammatory molecules such as leptin, adiponectin, TNF-alpha, IL-6, and acute phase proteins, which induce the inflammation and potentially generate metabolic diseases. CONCLUSION: According to these, we can link adipose tissues to inflammation, but we need to affirm the actual levels and roles of adipose tissue-derived proinflammatory molecules in human body.
Acute-Phase Proteins ; Adipocytes ; Adiponectin ; Adipose Tissue* ; Atherosclerosis ; Bone Marrow ; Dendritic Cells ; Fatty Acids, Unsaturated ; Human Body ; Immune System* ; Inflammation ; Interleukin-6 ; Leptin ; Lipolysis ; Lymph Nodes ; Macrophages ; Metabolic Diseases ; Monocytes ; Negotiating ; Obesity ; Transcriptome ; Tumor Necrosis Factor-alpha

Hemangiopericytoma is a rare tumor, and especially when it arises in the peritoneal cavity. We present here the case of a 60-year-old woman with an isolated recurrent hemangiopericytoma in the liver. The patient presented to us for evaluation of palpable RUQ mass 7 years after she had undergone her first resection of a malignant hemangiopericytoma arising from the greater omentum. She has been lost to follow up 6 months after the first surgery. Various imaging studies showed a single large liver tumor that was hypervascular, well-capsulated and had central necrosis. She was negative for HBs-Ag and Anti-HCV. Under an impression of the recurrent malignant hemangiopericytoma, a right trisegmentectomy was performed for complete resection of the tumor. The pathological examination confirmed the diagnosis of recurrent hemangiopericytoma. Even though the incidence of hemangiopericytomas is low, malignant hemangiopericytomas have displayed frequent recurrences after long disease- free periods. A recurrent hemangiopericytoma is not easily detected early during follow-up until it is symptomatic because this tumor has no specific tumor marker and it has diverse sites of recurrence. We think that Positron Emission Tomogram (PET) can be a useful tool for detection of recurrent hemangiopericytoma. We describe herein the clinically relevant information about hemangiopericytomas, and we particulary focus on the features of this tumor after the surgical resection.
Diagnosis ; Electrons ; Female ; Follow-Up Studies ; Hemangiopericytoma* ; Humans ; Incidence ; Liver Neoplasms* ; Liver* ; Lost to Follow-Up ; Middle Aged ; Necrosis ; Omentum ; Peritoneal Cavity ; Recurrence

PURPOSE: Tumor recurrence after partial hepatectomy for hepatocellular carcinoma is a major cause of death from this disease. Among those recurrences, when it occurs immediate during the postoperative period, it may due to the overt expression of pre-existing micrometastases or circulating disseminated cancer cells. Therefore; we evaluate herein the risk factors for the immediate postoperative period fatal recurrence to help establish effective preventive countermeasures against these fatal recurrences. METHODS: From 1994 to 2004, the 269 patients in this study all had greater than 6 months of follow-up after curative resection for HCC at our medical center. Those patients who had a fatal recurrence that included diffuse intra-hepatic recurrence or multiple systemic recurrence within 6 months after hepatectomy, and all of the patients who didn't have a fatal recurrence within 6 month after resection of HCC were compared. The clinicopathological factors associated with immediate postoperative recurrence were then analyzed. RESULTS: The overall postoperative mortality was 1%. There were 30 patients in the immediate postoperative group (the subjective group) among the total 269 patients. Among the subjective group patients, 20 patients had diffuse intra-hepatic recurrence and remained 10 patients had multiple systemic recurrence. The mean disease free survival period of the subjective group was 3.9+/-1.7 months and the mean survival period after recurrence was 6.7+/-6.1 months. On multivariate analysis, a serum alpha-fetoprotein level greater than 1, 000 ng/ml (p=0.019; odds ratio: 2.98), a tumor size greater than 6.5 cm (p=0.03; odd ratio: 2.98), and the presence of microvascular invasion (p=0.01; odd ratio: 4.89) were associated with the risk factors for immediate postoperative fatal recurrence. CONCLUSION: These findings can be important indicators to establish countermeasures against immediate postoperative period fatal recurrence, and the high risk patients would also be good candidates for clinical trials with adjuvant anti-cancer treatments such as early postoperative TACE, immunotherapy, anti-angiogenic treatment and so on.
alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Cause of Death ; Disease-Free Survival ; Follow-Up Studies ; Hepatectomy ; Humans ; Immunotherapy ; Mortality ; Multivariate Analysis ; Neoplasm Micrometastasis ; Odds Ratio ; Postoperative Period ; Recurrence* ; Risk Factors*

OBJECTIVE: To investigate the histologic features of the uterus and adnexae extirpated from gender identity disorder (GID) patients that received depot androgen injection. METHODS: We reviewed the histologic findings of the uterus and adnexae removed from sixteen GID patients, who had taken depot androgen injection for 5~168 months. RESULTS: Fourteen patients (87.5%) showed the atrophied epithelium of exocervix and all of 16 patients (100%) showed the atrophy of endometrium. Seven patients (43.7%) showed multiple cystic follicles in the ovarian cortex and 6 patients (37.5%), 3 patients (18.7%) showed corpus albicans and corpus luteum, respectively. CONCLUSIONS: Exogenous androgen induced atrophy of cervix and endometrium. This effect was more prominent in the endometrium. In addition, PCO-like histologic features were observed in the ovary.
Atrophy ; Cervix Uteri ; Corpus Luteum ; Endometrium ; Epithelium ; Female ; Gender Identity* ; Humans ; Ovary ; Uterus*

OBJECTIVES: To assess the distribution of social support, and explore its effects on self-rated health status in a low income neighborhood of Seoul, Korea. METHODS: In September 2001 we conducted a survey in a low income neighborhood of Seoul, Korea, in which 862 residents, aged 18 years or over, participated. We measured the general sociodemographic characteristics, self-rated health status and social support with the instrument developed from Korean translation of the Medical Outcomes Study Social Support Survey (MOS-SSS) scale of the US. Logistic regression was used to identify the determinants of social support, and explore its effects on self-rated health status. RESULTS: Lower social class, women or divorced people had much less social support compared to higher social class, men or those never married, respectively. Those families on much lower income also received less social support. Social support has a positive impact on the self-rated health status, which remains statistically significant even when other relevant variables are adjusted. CONCLUSIONS: This study suggests that social support has an important role in health, and the socially disadvantaged have lower social support. Therefore, to improve the health status of the poor, it is necessary to encourage community participation, and develop strategies that could strengthen their provision of social support.
Consumer Participation ; Divorce ; Female ; Humans ; Korea* ; Logistic Models ; Male ; Residence Characteristics* ; Seoul* ; Single Person ; Social Class ; Vulnerable Populations

B cell activation factor (BAFF) is a novel member of the TNF ligand superfamily, mainly produced by myeloid cells. BAFF has been shown to participate in B-cell survival and B- and T-cell maturation. BAFF expression in adipocytes has been recently demonstrated. In the current study, we verified that BAFF expression is increased during adipocyte differentiation. BAFF expression was augmented by TNF-alpha treatment and was decreased by rosiglitazone treatment. BAFF secretion in lean and in ob/ob mice sera were compared and smaller amount of BAFF was secreted in ob/ob mice. mRNA and protein expression were different between epididymal and visceral adipose tissue. BAFF expression was also increased in ob/ob mouse adipose tissue. We sought to identify known BAFF receptors (BAFF-R, BCMA, and TACI) in adipocytes, and determined that all three were present and upregulated during adipocyte differentiation. However, the expression of TACI was distinct from that of BAFF-R and BCMA under TNF-alpha and BAFF ligand treatment. BAFF-R and BCMA expression levels were upregulated under pro-inflammatory conditions, but TACI was reduced. Conversely, BAFF-R and BCMA expression levels were downregulated by rosiglitazone treatment, but TACI was increased. Taken together, our results suggest that BAFF may be a new adipokine, representing a link between obesity and inflammation.
Adipocytes/cytology ; Adipokines/biosynthesis/*physiology ; Animals ; B-Cell Activating Factor/biosynthesis/*physiology ; B-Cell Activation Factor Receptor/metabolism ; Cell Differentiation ; Hypoglycemic Agents/pharmacology ; Inflammation/*metabolism ; Mice ; Obesity/*metabolism ; Thiazolidinediones/pharmacology ; Tumor Necrosis Factor-alpha/pharmacology

PURPOSE: The main purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. MATERIAL AND METHODS: A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current payment rates of individual services. RESULTS: The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12- 2.55 times lower in total body irradiation. CONCLUSION: We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.
Classification* ; Fee-for-Service Plans ; Hospital Costs ; Humans ; Radiation Oncology* ; Whole-Body Irradiation

OBJECTIVE: This study was conducted to elucidate the associations of HLA with systemic sclerosis (SSc) in Koreans. METHODS: HLA associations with SSc according to SSc-specific autoantibody status and clinical subsets (diffuse and limited) were investigated. HLA-A, B, and C antigens were typed by the serological method using microlymphocytotoxicity test, and HLA-DR by DNA typing method using PCR-reverse hybridization and PCR-SSCP in 56 Korean patients with SSc and 226 healthy controls. For SSc patients, anti-Scl-70 and anicentromere antibodies were tested by double immunodiffusion and indirect immunofluorescence, respectively. RESULTS: The results of HLA class I antigen typing showed that the frequencies of HLA-A24, B52 and B62 were increased, whereas those of A33, B44 and B58 were decreased in SSc patients compared to healthy controls. The frequency of HLA-DR2 was significantly increased, whereas that of HLA-DR13 was decreased in patients with SSc compared to controls. Among HLA-DR2 alleles, both HLA-DRB1*1501 and *1502 were increased in SSc patients compared to controls. According to clinical status, HLA-DRB1*1501 was increased in limited SSc patients and that of DRB1*1502 was increased both in diffuse and limited SSc patients compared to controls. According to autoantibody status, HLA- DRB1 1502 was significantly increased in anti-Scl-70-positive SSc patients and that of DRB1 1501 was increased in anti-Scl-70-negative SSc patients compared to controls. The association of HLA-DR2 alleles with SSc according to clinical subsets and anti-Scl-70 antibody status revealed that the frequency of HLA- DRB1 *1501 was significantly increased in anti-Scl-70-negative limited SSc patients compared to controls. CONCLUSIONS: These results suggest that different HLA-DR2 alleles are associated with different types of SSc in Koreans. HLA-DRB1 1502 shows strong association with anti-Scl-70-positive SSc, and DRB1 1501 with anti-Scl-70-negative limited SSc. It is concluded that the pathogenesis of SSc in Koreans is in part, based on the same genetic background.
Alleles ; Antibodies ; Asian Continental Ancestry Group ; DNA Fingerprinting ; Fluorescent Antibody Technique, Indirect ; HLA-A Antigens ; HLA-A24 Antigen ; HLA-DR Antigens ; HLA-DR2 Antigen ; HLA-DRB1 Chains ; Humans ; Immunodiffusion ; Scleroderma, Systemic*

Blunt trauma to the chest may result in various cardiac injuries. But traumatic myocardial infarction with coronary artery fistula as a complication of chest trauma has been reported in very few cases. The etiology of myocardial infarction is not entirely clear. A 40 years old male was admitted after a traffic accident. He complained of acute retrosternal pain of about one hours duration. There was an area of contusion over the right sternal border. The ECQ showed deep Q wave and elevated ST segments in leads 2, 3 and aVF. There was a considerable increase in creatine kinase(CK) peak level and a CK-MB fraction. Coronary angiography revealed a total proximal occlusion of the right coronary that communicated directly with the right atrium. The left ventridulogram showed hypokinesia of the inferior wall. He was managed with conservative treatments and has remained well sebsequently. We reported a middle aged man who developed an acute transmural inferior wall myocardial infarction associated with coronary artery fistula secondary to blunt cheat trauma in an automobile accident.
Accidents, Traffic ; Adult ; Automobiles ; Contusions ; Coronary Angiography ; Coronary Vessels* ; Creatine ; Fistula* ; Heart Atria ; Humans ; Hypokinesia ; Inferior Wall Myocardial Infarction* ; Male ; Middle Aged ; Myocardial Infarction ; Thorax*

PURPOSE: Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC. MATERIALS AND METHODS: Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week. RESULTS: Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed. CONCLUSION: The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
Aged ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lymph Nodes ; Pneumonia ; Retrospective Studies ; Survival Rate