Apoptosis or programmed cell death plays an essential role in chemotherapy-induced tumor cell killing, and inducers of apoptosis are commonly used in cancer therapy. Treatment with Zelkova serrata extracts was performed in human gingival fibroblast (HGF), mouth epidermoid carcinoma cell (KB), lower gingival squamous cancer cell (YD38) and tongue mucoepidermoid carcinoma cells (YD15). We observed that extract prepared from Zelkova serrata twig selectively inhibited proliferation of various oral cancer cells, but not normal gingival fibroblasts, in a dose-dependent manner. Caspase-8-mediated apoptosis was induced by treatment with the extract only in mouth epidermoid carcinoma and not in other types of cancer cells, including lower gingival squamous cell carcinoma. The selective apoptotic effect of Zelkova serrata twig extract in mouth epidermoid carcinoma was dependent on normal p53 status. Apoptosis was not remarkably induced by treatment with the extract in either lower gingival squamous or tongue mucoepidermoid carcinoma cells, both of which contain abnormalities of p53. Upon treatment with Zelkova serrata twig extract, mouth epidermoid carcinoma cells accumulated in S phase by activation of p21. These data indicate that Zelkova serrata twig extract exerted a cancer type-specific, p53-dependent apoptotic effect and disturbed the cell cycle, which suggests that herbal medicine could be a treatment for specific types of cancers.
Antineoplastic Agents ; chemistry ; therapeutic use ; Apoptosis ; drug effects ; Carcinoma, Squamous Cell ; drug therapy ; enzymology ; pathology ; Caspase 3 ; drug effects ; Cell Line, Tumor ; Fibroblasts ; drug effects ; enzymology ; Growth Inhibitors ; chemistry ; therapeutic use ; Humans ; Mouth Neoplasms ; drug therapy ; enzymology ; pathology ; Phytotherapy ; Plant Extracts ; chemistry ; therapeutic use ; Signal Transduction ; drug effects ; Tumor Suppressor Protein p53 ; drug effects ; Ulmaceae ; chemistry

BACKGROUND: Recentry, the prevalence of HBsAg in children has been gradually decreased in Korea may be due to extensive vaccination. The object of this study is to identify the HbsAg positive rate in 6 to 7 year-old school children in Seoul and to outline the surveilance status of the HBsAg positive subjects. METHODS: We analyzed HBV mass screening results of 120,106 6 to 7-year-old school children in Seoul. For 188 HBsAg positive children who complied with the follow up visit, we tested HBeAg, LFT and interviewed their parents. We also compared the questionnaire results of HbsAg positive group with those of 694 random-sampled HBsAg negative controls. RESULTS: The overall HBsAg positive rate was 0.79%(0.81% in boys and 0.76% in girls). Children in poverty area showed significantly higher rate(1.04%) of HBsAg positivity than those in non-poverty area(0.77%). Among HbsAg positive children, 86.7% was also HBeAg positive and had higher ALT levels than those with negative HBeAg. More than 70% of parents of HBsAg positive children was not aware of their children's HBsAg status before the screening and 28.7% of mothers did not know their own HbsAg status. The complete vaccination rate of the HBsAg positive and HBsAg negative group were 75.5% and 77.4% respectively, which shows no significant difference. Having family history of HBV infection was significantly associated with HBsAg positive status(OR=32. 8). CONCLUSIONS: The HBsAg positive rate in 6- to 7-year-old school children has decreased in Korea compared to the data from previous studies. However in the aspects of public awareness and health care compliance, there are much room for quality improvement. Above all, more rigorous and continuous surveilance system is required for antenatal and postpartum care.
Child* ; Compliance ; Delivery of Health Care ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Mass Screening ; Mothers ; Parents ; Pilot Projects* ; Postnatal Care ; Poverty Areas ; Prevalence ; Quality Improvement ; Seoul* ; Vaccination ; Surveys and Questionnaires

An appendicocolic fistula is a rare disease. It seems likely that the appendix becomes adherent to the viscus either before or after its perforation due to appendicitis, so surgeons may become confused when an emergency appendectomy in done. We report one case of an appendicocolic fistula to draw attention to the importance of this fistula and to describe the clinical, the diagnostic, and the therapeutic aspects of the disease.
Appendectomy ; Appendicitis ; Appendix ; Emergencies ; Fistula* ; Rare Diseases

PURPOSE: Acute dysbarism is a potentially lethal injury associated with environmental medicine. Therefore, prompt treatment, including transportation of victims, is important for the best prognosis. The aim of this study was to examine transportation routes of patients with acute dysbarism for the best prognosis in Korea. METHODS: Geography of South Korea was analyzed using the geographic information system (GIS). The study examined two scenarios using transportation analysis, which relies on a GIS base and pressure variation during air and ground transportation. Given the practical assumptions, we propose some heuristic transportation routes based on the simulation of altitude, transportation time, and availability of related factors. RESULTS: Currently, transportation by ground to the treatment facilities always passes high altitude areas above 152 feet. Also, available helicopters for air transportation could not approach the treatment facilities due to the limitation of flying distance and insufficiency of medical staff and treatment equipment. Altitude variation and delayed time were identified during the period of transportation by ground from Ganneung or Incheon to Tongyoung. Heuristic algorism through the above facts recommends air transport along coasts as the best method for transportation from Ganneung or Incheon to Tongyoung. CONCLUSION: In Korea, transportation by ground was not expected to result in the best prognosis for patients with acute dysbarism. Transportation by air should be considered first as the method of transportation. Also, for the best treatment of patients with acute dysbarism, additional treatment facilities need to be established in the west coast region.
Aircraft ; Altitude ; Decompression Sickness ; Diptera ; Environmental Medicine ; Foot ; Geographic Information Systems ; Geography ; Geography, Medical ; Humans ; Incheon ; Korea ; Medical Staff ; Prognosis* ; Transportation of Patients ; Transportation*

This study was conducted to identify the factors for serum cholesterol level among Korean Air Force pilots. We obtained risk factors for 408 pilots examined during period from January 1996 through March 1997. The associations between total cholesterol, LDL-cholesterol, triglyceride, HDL-cholesterol and age, body mass Index(BMI), smoking, drinking, blood pressure, flight time and fat intake were analyzed. The mean serum total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride levels were 161.8+/-31.0 mg/dl, 475+/-11.0 mg/dl, 93.1+/-30.2 mg/dl, and 106.5+/-61.3 mg/dl respectively. Possible risk factors were total flight time, BMI, smoking, drinking, exercise, flight, and fighter or not. Total flight time and BMI were statistically significant factors In serum cholesterol level while controlling for the effect of the remaining factors. The longer the total flight time, the higher the level of serum total cholesterol. Total flight time, BMI, and drinking amount were statistically significant factors in serum HDL-cholesterol while controlling for the effect of the remaining factors. The higher the BIM, the lower the level of HDL-cholesterol. BMI was a statistically significant factor in seurm LDL-cholesterol while controlling for the effect of remaining factors. Total flight time, BIM, and flight were statistically significant factors in serum triglyceride while controlling for the effect of the remaining factors. Conclusively, BIM was a only significant factor in all four lipid levels, and total flight time took an affect to total cholesterol, HDL-cholesterol, and triglyceride levels.
Blood Pressure ; Cholesterol ; Drinking ; Risk Factors ; Smoke ; Smoking ; Triglycerides

BACKGROUND: Paradoxical embolism through the patent foramen ovale (PFO) is a well-recognized mechanism for otherwise unexplained ischemic stroke. Although transthoracic contrast echocardiography (TCE) has been used frequently for noninvasive diagnosis of right to left shunt through PFO, its diagnostic accuracy appears limited, especially in patients with poor acoustic window. Since harmonic imaging (HI) can enhance the definition of contrast microbubbles, theoretical advantages of HI in the detection of right to left shunt through PFO using microbubbles can be considered. However, there are few data regarding the diagnostic efficacy of HI in the detection of right to left shunt through PFO. The purpose of this study was to compare the diagnostic value of transthoracic HI in the detection of right to left shunt through PFO in patients with stroke with that of fundamental imaging (FI). Methods: One hundred thirty-six consecutive patients with stroke (82 male, mean age:9) underwent TCE in both HI and FI and transesophageal echocardiography (TEE) during rest and Valsalva maneuver with intravenous administration of agitated saline. PFO was judged to be present if microbubbles appeared in the left atrium within 3 cardiac cycles of their appearance in the right atrium. TEE was regarded as the gold standard for assessing the diagnostic accuracy of TCE. Results: Right to left shunt through PFO was detected in 40 of 136 patients by TEE (29.4%). FI of TCE detected shunt through PFO in only 9 of 136 patients (6.6%). In contrast, HI detected shunt through PFO in 25 of 136 patients (18.4%). The overall sensitivity and specificity of FI and HI for detection of right to left shunt through PFO were 22.5%, 62.5% (p<0.05) and 100%, 100%, respectively. Valsalva maneuver during HI significantly increased the detection rate of shunt through PFO (during rest in 9 and during Valsalva maneuver in 25, p<0.05). CONCLUSION: HI with contrast microbubble injection significantly enhanced the detection of right to left shunt through PFO in patients with ischemic stroke compared with FI by transthoracic approach.
Acoustics ; Administration, Intravenous ; Diagnosis ; Dihydroergotamine ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Heart Atria ; Humans ; Male ; Microbubbles ; Sensitivity and Specificity ; Stroke ; Valsalva Maneuver

OBJECTIVE: To analyze the indications, clinical features, cytogenetic results and complications of amniocentesis and to determine the efficacy of antenatal genetic amniocentesis. METHODS: We analyzed retrospectively maternal age, gestational age, indications, transplacental puncture, frequency, discoloration of amniotic fluid, karyotype and complications in 325 cases of prenatal genetic amniocentesis performed at Chungnam National University Hospital from January 2000 to December 2002. RESULTS: The most common age group was from 30 to 34 (31.4%) and mean age was 32.7 years old. 85.3% of cases were performed at 16th-20th gestational weeks. Abnormal maternal serum markers were the most common indication of amniocentesis (56.0%) and the second most common indication was maternal age over 35 (33.2%). Abnormal karyotypes were found in 12 cases (3.6%) and normal variants were 21 cases (6.5%). Numerical aberration were 9 cases (2.7%) and structural aberration were 3 cases (0.3%). Among the autosomal aberrations, Down syndromes were 5 cases and Edward syndrome was 1 case. Among the sex chromosomal aberrations, 47,XXX were 2 cases and Turner syndrome was 1 case. As the increasing maternal age, the incidence of abnormal karyotype was increased. Procedure-related complications occurred in 11.7% of cases and fetal loss rate was 7.4%. No significant associations were found between procedure-related complications and maternal age, gestational age, transplacental puncture, frequency, discoloration of amniotic fluid, and antibiotic treatment. CONCLUSION: Amniocentesis is useful for prenatal genetic diagnosis in pregnancies with increasing risk of chromosome aberrations, such as advanced maternal age, abnormal maternal serum markers or abnormal US findings. Further studies are necessary to identify risk factors of complications after invasive procedure.
Abnormal Karyotype ; Amniocentesis* ; Amniotic Fluid ; Biomarkers ; Chromosome Aberrations ; Chungcheongnam-do ; Cytogenetic Analysis* ; Cytogenetics* ; Diagnosis ; Female ; Gestational Age ; Humans ; Incidence ; Karyotype ; Maternal Age ; Pregnancy ; Pregnancy Trimester, Second* ; Punctures ; Retrospective Studies ; Risk Factors ; Turner Syndrome

Cerebral rete mirabile is a unusual form of chronic cerebrovascular occlusive disease characterized usually by bilateral stenosis of distal internal carotid arteries and their vicinity, by a hazy network of collateral circulation at the base of brain called moyamoya vessels and clinically by recurring hemispheric ischemic attack in children. We have reported here 2 cases of cerebral rete mirabile in children and performed newly developed operative procedure which we think is an ideal surgical method for treatment of this disease in children and is compared with other surgical treatment.
Brain ; Carotid Artery, Internal ; Child* ; Collateral Circulation ; Constriction, Pathologic ; Humans ; Ischemia ; Surgical Procedures, Operative

OBJECTIVES: Although there have been several reports that described characteristics for young age stroke, information regarding very young age (18–30 years old) has been limited. We aimed to analyze demographic factors, stroke subtype, and 3-month outcome in acute ischemic stroke patient who have relatively very young age in multicenter stroke registry. METHODS: We evaluated all 122 (7.1%) consecutive acute ischemic stroke (within 7 days after symptom onset) patients aged 18 to 30 from 17,144 patients who registered in multicenter prospective stroke registry, 1997 to 2012. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) and stroke outcome was defined by modified Rankin scale (mRS) at 3 months after index stroke. RESULTS: The mean age of all included patients was 25.1±3.7 years and 76 patients (62.2%) were male. The median NIHSS at admission was 4. Considering stroke subtype, 37 patients (30.3%) had stroke of other determined etiology (SOD), 37 (30.3%) had undetermined negative evaluation (UN) and 31 (25.4%) had cardioembolism (CE) were frequently noted. After adjusting age, sex and variables which had P<0.1 in univariable analysis (NIHSS and stroke subtype), CE stroke subtype (odds ratio, 4.68; 95% confidence interval, 1.42–15.48; P=0.011) were significantly associated with poor functional outcome (mRS≥3). CONCLUSION: In very young age ischemic stroke patients, SOD and UN stroke subtype were most common and CE stroke subtype was independently associated with poor discharge outcome.
Carotid Artery, Internal, Dissection ; Cerebral Infarction ; Demography ; Humans ; Male ; National Institutes of Health (U.S.) ; Prognosis ; Prospective Studies ; Stroke* ; United Nations ; Vertebral Artery Dissection

Multiple RBC transfusions inevitably lead to a state of iron overload before and after high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT). Nonetheless, iron status during post-SCT follow-up remains unknown. Therefore, we investigated post-SCT ferritin levels, factors contributing to its sustained levels, and organ functions affected by iron overload in 49 children with high-risk neuroblastoma who underwent tandem HDCT/autoSCT. Although serum ferritin levels gradually decreased during post-SCT follow-up, 47.7% of the patients maintained ferritin levels above 1,000 ng/mL at 1 yr after the second HDCT/autoSCT. These patients had higher serum creatinine (0.62 vs 0.47 mg/mL, P = 0.007) than their counterparts (< 1,000 ng/mL). Post-SCT transfusion amount corresponded to increased ferritin levels at 1 yr after the second HDCT/autoSCT (P < 0.001). A lower CD34+ cell count was associated with a greater need of RBC transfusion, which in turn led to a higher serum ferritin level at 1 yr after HDCT/autoSCT. The number of CD34+ cells transplanted was an independent factor for ferritin levels at 1 yr after the second HDCT/autoSCT (P = 0.019). Consequently, CD34+ cells should be transplanted as many as possible to prevent the sustained iron overload after tandem HDCT/autoSCT and consequent adverse effects.
Antigens, CD34/metabolism ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Benzoic Acids/therapeutic use ; Blood Transfusion/*adverse effects ; Child ; Child, Preschool ; Creatinine/blood ; Ferritins/blood ; Follow-Up Studies ; Humans ; Infant ; Iron Chelating Agents/therapeutic use ; Iron Overload/*etiology ; Neuroblastoma/drug therapy/*therapy ; Retrospective Studies ; Risk Factors ; *Stem Cell Transplantation ; Transplantation, Autologous ; Triazoles/therapeutic use