Fatal complications including cerebral edema and neurologic collapse occur during treatment of diabetic ketoacidosis(DKA). A 6-week-old female infant with fever, dehydration and drowsy mental status was diagnosed as DKA and neurologically deteriorated during treatment. The cranial computed tomography scan revealed multifocal brain infarctions of the left caudate nucleus, bilateral frontal periventricular white matter, and right parietal cortex. A moderate amount of hemorrhage was also noted in both lateral ventricles. She recovered rapidly with supportive treatment over time. The clinical course and radiologic findings of this patient emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.
Brain Edema ; Brain Infarction* ; Brain* ; Caudate Nucleus ; Child ; Dehydration ; Diabetic Ketoacidosis* ; Female ; Fever ; Hemorrhage* ; Humans ; Infant* ; Lateral Ventricles ; Rabeprazole

The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.
Acquired Immunodeficiency Syndrome* ; Coinfection ; Gastrointestinal Tract ; HIV ; HIV Infections ; Humans ; Incidence ; Lymph Nodes ; Peritoneum ; Respiratory Distress Syndrome, Adult ; Tuberculosis* ; Viscera

Objetives: Identification of target genes for ethanol in neurons is important for understanding its molecular and cellular mechanism of action and the neuropathological changes seen in alcoholics. The purpose of this study is to identify of altered gene expression after acute treatmet of ethanol in rat gliom cells. METHODS: We used high density cDNA microarray chip to measure the expression patterns of multiple genes in cultured rat glioma cells. DNA microarrays allow for the simultaneous measurement of the expression of several hundreds of genes. RESULTS: After comparing hybridized signals between control and ethanol treated groups, we found that treatment with ethanol increased the expression of 15 genes and decreased the expression of 12 genes. Upregulated genes included Orthodenticle(Drosophila) homolog 1, procollagen type II, adenosine A2a receptor, GATA-bindning protein 2. Downregulated genes included diacylglycerol kinase beta, PRKC, Protein phosphatase 1, clathrin-associated protein 17, nucleoporin p58, proteasome. CONCLUSION: The gene changes noted were those related to the regulation of transcription, signal transduction, second messenger systems. modulation of ischemic brain injury, and neurodengeneration.Although some of the genes were previously known to be ethanol responsive, we have for the most part identified novel genes involved in the brain response to ethanol.
Alcoholics ; Animals ; Brain ; Brain Injuries ; Collagen Type II ; Diacylglycerol Kinase ; Ethanol* ; Gene Expression* ; Glioma* ; Humans ; Microarray Analysis* ; Neurons ; Nuclear Pore Complex Proteins ; Oligonucleotide Array Sequence Analysis ; Proteasome Endopeptidase Complex ; Protein Phosphatase 1 ; Rats* ; Receptor, Adenosine A2A ; Second Messenger Systems ; Signal Transduction

BACKGROUND: Hypertension and age are recognized as important risk factors for left ventricular (LV) diastolic dysfunction. Some studies have shown that diabetes itself may also be an independent risk factor for LV diastolic dysfunction, although this is controversial. The aim of this study was to determine the factors associated with LV diastolic dysfunction in patients with type 2 diabetes in the absence of hypertension or ischemic heart disease (IHD). METHODS: Participants in this study consisted of 65 type 2 diabetes patients (M : F = 45 : 20; mean age 51 [26 to 76] years; mean body mass index [BMI] 25.0 +/- 2.5 kg/m2) without hypertension, heart disease, or renal disease. Individuals with ischemic electrocardiographic changes were excluded. LV diastolic function was evaluated by Doppler echocardiographic studies. RESULTS: Fifteen patients (23.1%) showed LV diastolic dysfunction on Doppler echocardiographic studies. Patients with LV diastolic dysfunction were older than those without diastolic dysfunction (60.0 +/- 2.5 vs. 50.5 +/- 1.9 years; P < 0.01). After adjusting for age and sex, BMI was higher (26.6 +/- 0.7 vs. 24.6 +/- 0.3 kg/m2; P < 0.01) and diabetes duration was longer (9.65 +/- 1.48 vs. 4.71 +/- 0.78 years; P < 0.01) in patients with LV diastolic dysfunction than in those without diastolic dysfunction. There were no differences in sex, smoking, blood pressure, lipid profiles, hemoglobin A1C, fasting glucose, fasting insulin, or diabetic microvascular complications between the LV diastolic dysfunction group and the normal diastolic function group. After adjusting for age, sex, and BMI, diabetes duration was found to be independently associated with LV diastolic dysfunction (odds ratio 1.38; confidence interval 1.12 to 1.72; P = 0.003). CONCLUSION: These results suggest that diabetes duration may be a risk factor for LV diastolic dysfunction in type 2 diabetic patients without hypertension or IHD.
Blood Pressure ; Body Mass Index ; Diabetes Mellitus ; Electrocardiography ; Fasting ; Glucose ; Heart Diseases ; Hemoglobins ; Humans ; Hypertension ; Insulin ; Myocardial Ischemia ; Risk Factors ; Smoke ; Smoking

PURPOSE: A multicenter study was performed to evaluate the clinical characteristics and the results of chemotherapy in patients with testicular tumor. MATERIALS AND METHODS: We retrospectively reviewed the records of 121 patients with testicular tumor treated at five university hospital between 1980 and 1997. We analyzed the clinical characteristics, additional treatments after orchiectomy and results of chemotherapy. RESULTS: Patients age ranged from 1 month to 74 years with a mean of 24 years. The common presenting symptoms were scrotal swelling in 63 patients, palpable mass in 50, and testicular pain in 12. The location of the tumor was on the right side in 62, left in 58, and both in 1 with lymphoma. The histologic type was germinal neoplasm in 101 patients, nongerminal neoplasm in 1, and other tumors in 19. Clinically, 76 patients(62.8%) were stage I, 16(13.2%) stage IIa, 12(9.9%) stage IIb, 3(2.5%) stage IIc, 9(7.4%) stage III and 5(4.1%) stage IV. After orchiectomy, 73 patients(60.3%) were underwent close observation, 30(24.8%) chemotherapy, 14(11.6%) radiation therapy, 3(2.5%) radiation plus chemotherapy and 1(0.8%) retroperitoneal lymph node dissection. Among the 33 chemotherapy patients, 12(36.4%) patients achieved a clinical complete remission(CR), 5(15.2%) partial remission(PR), 4(12.1%) minor response and stabilization, 5(15.2%) progression and 7(21.2%) patients were follow-up loss, and the overall clinical response rate was 65.4%. Among the 18 chemotherapy patients with nonseminomatous germ cell tumor(NSGCT), 9(50.0%) patients achieved a clinical CR, 4(22.2%) PR, 1(5.6%) minor response and stabilization, 2(11.1%) progression and 2(11.1%) patients were follow-up loss, and the overall clinical response rate was 81.3%. CONCLUSIONS: Our study group was relatively small and insufficient to evaluate the chemotherapeutic results, but NSGCT seems to have a better clinical response to chemotherapy.
Drug Therapy ; Follow-Up Studies ; Germ Cells ; Humans ; Lymph Node Excision ; Lymphoma ; Orchiectomy ; Retrospective Studies ; Testis*

BACKGROUND: Phospholipase C (PLC) plays an important role in cellular signal transduction and is thought to be critical in cellular growth, differentiation and transformation of certain malignancies. Two second messengers produced from the enzymatic action of PLC are diacylglycerol(DAG) and lnositol 1, 4, 5-trisphosphate(IP3). These two second messengers are important in down stream signal activation of protein kinase C and intracelluar calcium elevation. In addition, functional domains of the PLC isozymes, such as Src homology 2(SH2) domain, Src homology 3(SH3) domain, and pleckstrin homology(PH) domain play crucial roles in protein translocation, lipid membrane modification and intracellular memrane trafficking which occur during various mitogenic processes. We have previously reported the presence of PLC-γ1, γ2, β1, β3, and δ1 isozymes in normal human lung tissue and tyrosine-kinase-independent activation of phospholipase C-γisozymes by tau protein and AHNAK. We had also found that the expression of AHNAK protein was markedly increased in various histologic types of lung cancer tissues as compared to the normal lungs. However, the report concerning expression of various PLC isozymes in lung cancers and other lung diseases is lacking. Therefore, in this study we examined the expression of PLC isozymes in the paired surgical specimens taken from lung cancer patients. METHODS: Surgically resected lung cancer tissue samples taken from thirty seven patients and their paired normal control lungs from the same patients. The expression of various PLC isozymes were studied. Western bolt analysis of the tissue extracts for the PLC isozymes and immunohistochemistry was performed on typical samples for localization of the isozyme. RESULTS: In 16 of 18 squamous cell carcinomas, the expression of PLC-γ1 was increased. PLC-γ1 was also found to be increased in all of 15 adenocarcinoma patients. In most of the non-small cell lung cancer tissues we had examined, expression of PLC-δ1 was decreased. However, the expression of PLC-δ1 was markedly increased in 3 adenocarcinomas and 3 squamous carcinomas. Although the numbers were small, in all 4 cases of small cell lung cancer tissues, the expression of PLC-δ1 was nearly absent. CONCLUSION: We found increased expression of PLC-γ1 isozyme in lung cancer tissues. Results of this study, taken together with our earlier findings of AHNAK protein-a putative PLD-γ, activator-over-expression, and the changes observed in PLC-δ1 in primary human lung cancers may provide a possible insight into the derranged calcium-inositol signaling pathways leading to the lung malignancies.
Adenocarcinoma ; Calcium ; Carcinogenesis ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans* ; Immunohistochemistry ; Isoenzymes* ; Lung Diseases ; Lung Neoplasms* ; Lung* ; Membranes ; Phospholipases ; Protein Kinase C ; Protein Transport ; Rivers ; Second Messenger Systems ; Signal Transduction ; Small Cell Lung Carcinoma ; tau Proteins ; Tissue Extracts ; Type C Phospholipases

Pulmonary complications of ulcerative colitis are relatively uncommon and may present as a variety of disorders. Ulcerative colitis-related interstitial lung disease is extremely rare. There are a few case reports of nonspecific interstitial pneumonia in ulcerative colitis worldwide but none in Korea. We report a patient with ulcerative colitis related biopsy-proven nonspecific interstitial pneumonia, who responded to prednisolone (1 mg/kg) and mesalazine therapy
Colitis, Ulcerative* ; Humans ; Korea ; Lung Diseases, Interstitial* ; Mesalamine ; Prednisolone ; Ulcer*

PURPOSE: This study was undertaken to analyze whether the p53 codon 72 single nucleotide polymorphism might be correlated with the risk and/or the prognosis of cervical cancer in Korean women. MATERIALS AND METHODS: Peripheral blood samples derived from patients with cervical squamous cell carcinoma (SCC) (n=68), cervical adenocarcinoma (n=37), cervical intraepithelial neoplasia (CIN) III (n=98) and normal controls (n=98) were examined. Germline genomic DNA was extracted from peripheral blood leukocytes and examined by PCR amplification of the specific alleles assay described by Storey et al.5 Statistical analysis was performed using the Chi-Square test or the Kaplan-Meier survival analysis, logistic regression analysis. RESULTS: The proportions of individuals who were homozygous for the proline allele, and heterozygous for the two allele, homozygous for arginine allele in each group were 15%, 47%, 38% in the SCC group; 6%, 7%, 24% in the adenocarcinoma group; 7%, 33%, 60% in the CIN III group; and 11%, 38%, 51% in the control group. No significant difference was found between the three groups (p>0.05). However there was a significant difference in the adenocarcinoma group (p<0.05). Arg/Arg homozygote reduced the risk of adenocarcinoma. No significant difference existed in 5-year survival rates in the three groups (p=0.22 in SCC, p=0.91 in adenocarcinoma). CONCLUSION: These findings suggest that Arg/Arg homozygocity of the p53 codon 72 would be a protective factor against the development of cervical adenocarcinoma.
Adenocarcinoma* ; Alleles ; Arginine ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Codon* ; DNA ; Female ; Homozygote ; Humans ; Leukocytes ; Logistic Models ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prognosis ; Proline ; Survival Rate ; Uterine Cervical Neoplasms

No abstract available.
Epilepsies, Partial* ; Headache* ; Hemianopsia ; Migraine Disorders ; Occipital Lobe*

Immunoglobulin G4-related disease (IgG4-RD) is characterized by extensive IgG4-positive plasma cells infiltration resulting in inflammation and fibrosis of the affected organs. Patient with IgG4-RD shows an excellent response to glucocorticoid therapy especially when given at early onset stages. IgG4-related sclerosing cholangitis (IgG4-SC) is considered biliary manifestation of IgG4-RD. The natural history and long-term prognosis of IgG4-SC is not well defined and most of the previous case series have reported short duration of follow-up. We present the case of development of decompensated liver cirrhosis from IgG4-related sclerosing cholangitis with a 6-year natural clinical course.
Cholangitis ; Cholangitis, Sclerosing* ; Fibrosis ; Follow-Up Studies ; Humans ; Immunoglobulins ; Inflammation ; Liver Cirrhosis* ; Liver* ; Natural History ; Plasma Cells ; Prognosis