To investigate effects of cytokines on rheumatoid synovial cells, proliferation and expression of cytokine and metalloproteinase genes were studied with the primary culture of rheumatoid synovial cells which was treated with TNF-alpha, GM-CSF, TGF-alpha, PDGF and IL-B. By [3H] thymidine incorporation assay, TGF-beta and PDGF increased proliferation of synovial cells by 1.5 and 2.5 folds respectively. Cytokine gene expression was assessed by RT-PCR. Rheumatoid synovial cells expressed constitutively TGF-beta and IL-B at a high level and IL-1B, GM-CSF, and MIP-1a at a relatively low level. TGF-beta, GM-CSF and PDGF increased IL-B expression. Expression of pro-inflammatory cytokines and chemokines was increased by GM-CSF and PDGF. Both GM-CSF and PDGF increased the expression of IL-1B, GM-CSF MIP-la and IL-8. In addition, GM-CSF enhanced expression of TNF-alpha. Stromelysin and collagenase are the major proteinases responsible for destruction ot joints in rheumatoid arthritis (RA). These genes were expressed constitutivefy in rheumatoid synovial cells. In summary, PDGF and GM-CSF may piay an important role by inducing or increasing expression of IL-1B, TGF-beta and PDGF by increasing proliferation of rheumatoid synovial cells.
Tumor Necrosis Factor-alpha

Wiskott-Aldrich syndrome is a rare inheritable disease. Though there are many reported cases in the world, there are only 3 reported cases in Korea. We experienced a 7 years old boy with Wiskott-Aldrich syndrome. The initial presentation was generalized petechiae due to thrombocytopenia. We diagnosed him to have idiopathic thrombocytopenic purpura and followed up him for several years. During follow-up the patient have been suffered from croup, perianal abscess, bronchitis, and otitis media. One year ago, inguinal mass developed and 3 months ago, cervical and axillary masses developed. The fine needle aspiration cytology and biopsy revealed angioimmunoblastic lymphadenopathy like atypical lymphoproliferative disorders associated with congenital immune deficiency. So we diagonsed the patient to have Wiskott-Aldrich syndrome through his clinical course and laboratory findings including eczema, persistent low platelet counts, low mean platelet volume, monoclonal gammopathy on serum electrophoresis and biopsy finding.
Abscess ; Biopsy ; Biopsy, Fine-Needle ; Bronchitis ; Child ; Croup ; Eczema ; Electrophoresis ; Follow-Up Studies ; Humans ; Immunoblastic Lymphadenopathy ; Korea ; Lymphoproliferative Disorders ; Male ; Mean Platelet Volume ; Otitis Media ; Paraproteinemias ; Platelet Count ; Purpura ; Purpura, Thrombocytopenic, Idiopathic ; Thrombocytopenia* ; Wiskott-Aldrich Syndrome*

To investigate the effect of disposable contact lenses (CL) on the corneal epithelial healing, a prospective study of 30 myopic epikeratoplasties which were divided into 3 groups according to the method for promoting the corneal epithelial healing was conducted. The groups are consisted of 10 eyes with pressure patch, 10 eyes with Acuvue(R) disposable CL and 10 eyes with SeeQuence(R) disposable CL. Corneal epithelial healing was completed in the pressure patch, Acuvue(R) CL and SeeQuence(R) CL group at 3.4, 3.5 and 3.4 postoperative days, respectively. Corneal epithelial healing rate during postoperative 1, 2 and 3 days are 0.33, O.78, and O.44mm2/hour in pressure patch group, O.24, O.92 and O.37mm2/hour in Acuvue(R) CL group, and O.30, O.79 and O.38mm2/hour in SeeQuence(R) CL group respectively. From the above results, it is concluded that there was no statistically significant difference of the corneal epithelial healing time and rate between the pressure patching and disposable bandage CL wearing after myopic epikeratoplasty.
Bandages* ; Contact Lenses* ; Epikeratophakia* ; Prospective Studies

This study was performed to investigate the corneal epithelial healing time and rate according to the method for promoting the reepithelization after myopic epikeratoplasty. A prospective study was conducted on 30 myopic epikeratoplasties which were divided into 3 groups according to the method for promoting the epithelial healing. The groups consisted of 10 eyes with pressure patches, 10 eyes with Acuvue(R) disposable contact lens (CL) and 10 eyes with SeeQuence(R) disposable CL. The cornea epithelial healing time were 3.4, 3.5 and 3.4 postoperative days for the pressure patch, Acuvue(R) CL and SeeQuence(R) CL groups, respectively. The corneal epithelial healing rates during postoperative 1, 2, and 3 days were 0.33, 0.78, and 0.44 mm2/hour for the pressure patch group; 0.24, 0.92 and 0.37 mm2/hour for the Acuvue(R) CL group; and 0.30, 0.79 and 0.38 mm2/hour for the SeeQuence(R) CL group. These results suggest that a disposable contact lens may not hinder epithelial healing compared with a pressure patch.
Adult ; Bandages ; Contact Lenses ; Cornea/*physiology/surgery ; *Corneal Transplantation ; Epithelium/physiology ; Female ; Humans ; Male ; Middle Aged ; Myopia/*physiopathology/surgery ; Prospective Studies ; Time Factors ; Wound Healing/*physiology

PURPOSE: Coloanal anastomosis (CAA) following ultralow anterior resection became more popular techniques for preservation of anal sphincter in distal rectal cancer. The purpose of this study is to evaluate a functional and oncologic safety of patients who underwent ultralow anterior resection and coloanal anastomosis for distal rectal cancer. METHODS: Forty-eight patients underwent coloanal anastomosis following ultralow anterior resection between January 1988 and January 1998. Main operative techniques were total mesorectal excision with autonomic nerve preservation. Colonic J pouch was made 8 cm in length with GIA 95. All patients were followed up for fecal or gas incontinence, frequency of bowel movement and local or systemic recurrences. RESULTS: Mean tumor distance from anal verge was 4.0 cm. Postoperative complications were transient urinary retention (N=7), anastomotic stenosis (N=3), anastomotic leakage (N=3), rectovaginal fistula (N=2), cancer positive margin (N=1; patient refuses reoperation). Overall recurrences occurred in 7/48 (14.5%). Local recurrence (N=1) and systemic recurrence (N=1) in Astler-Coller stage B2, local recurrence (N=1), systemic recurrence (N=2) and combined local and systemic recurrence (N=2) in Astler-Coller stage C2. Mean frequency of bowel movement were 6.1 per day at 3 month, 4.4 at 1 year and 3.1 at 2 years. Kirwan grade for fecal incontinence were 2.7 at 3 months, 1.8 at 1 year and 1.5 at 2 years. CONCLUSIONS: With careful selection of patients and good operative techniques, CAA can be performed safely in distal rectal cancer. Normal continence and acceptable frequency of bowel movements can be obtained at 1 year after operation without compromising the rate of local recurrence.
Anal Canal ; Anastomotic Leak ; Autonomic Pathways ; Colon ; Colonic Pouches ; Constriction, Pathologic ; Fecal Incontinence ; Humans ; Postoperative Complications ; Rectal Neoplasms* ; Rectovaginal Fistula ; Recurrence ; Urinary Retention

BACKGROUND: The majority of patients undergoing stem cell transplantation (SCT) require a blood transfusion until the complete engraftment. Because blood transfusion rules for patients with ABO-incompatible SCT are complicated, we developed an ABO-incompatible transfusion management system (ABO-ITMS) for accurate blood transfusion and improved manageability. METHODS: A committee composed of medical doctors, technicians, and a programmer developed ABO-ITMS during the eight months from July 2013 to February 2014. The program has been linked with other databases, including clinical and laboratory databases and resulted in a new subsystem of the health information system. Server computer's operating system was Window Server 2008, and the database manager program was Oracle 11g. Programming language was ASP.Net (VBScript, C #), and the server and client computer were used to connect to the web server using a web browser. RESULTS: ABO-ITMS was designed to follow three main steps by hematologic oncology clinic, laboratory physician, and blood bank. In the first step, a hematologic-oncology clinic doctor inputs SCT recipients' data and appropriate ABO group for each phase of post-transplantation. Laboratory physician enters the isoagglutinin titer and ABO group at the second step. Finally, blood bank workers enter the results of type, screening, and antibody identification. The patient's SCT information and the previous immunohematologic test results are shown on the screen. CONCLUSION: ABO-ITMS can replace the existing complicated system and workflow. ABO-ITMS will contribute to reducing medical error and improving quality of SCT recipient care.
Blood Banks ; Blood Transfusion* ; Health Information Systems ; Humans ; Mass Screening ; Medical Errors ; Programming Languages ; Stem Cell Transplantation* ; Web Browser

PURPOSE: Laparoscopic colorectal procedures are widely used for benign disease but controversial for malignant disease. In early colorectal cancer, laparoscopic colectomy can be performed safely on the basis of oncologic principles. The purpose of this study is to evaluate the safety and effectiveness of laparoscopic-assisted colorectal resection for malignant polyps and benign disease. METHODS: Twenty five patients submitted to surgical treatment between Oct. 1996 to June 2000 were reviewed retrospectively. RESULTS: Malignant polyps comprized 7 cases whose resection margins were all positive for cancer cells after endoscopic polypectomy and benign diseases in 18 cases (benign polyp: 7, diverticular disease: 4, submucosal tumor: 4 etc.). The common sugical procedures were anterior or low anterior resection (7 cases) and segmental resection (6 cases). There was no conversion to an open surgery. In malignant polyps, pathologic results revealed early cancer with no lymph node metastasis. There was no operative mortality. Postoperative recovery was uneventful except 2 cases (9.0%) of complications, which were, prolonged ileus in one patient and subcutaneous emphysema in another patient. CONCLUSIONS: Laparoscopic-assisted resection can be recommended as a safe and effective procedure for treatment of colonic malignant polyps and benign disease.
Colectomy ; Colon ; Colorectal Neoplasms ; Humans ; Ileus ; Laparoscopy ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Polyps* ; Retrospective Studies ; Subcutaneous Emphysema

STUDY DESIGN: A retrospective clinical and radiological analysis OBJECTIVES: To determine the relationship between the classifications of unstable burst fractures on the thoracolumbar region, radiologic studies, signal change area on MRA and analysis of the prognostic factors. SUMMARY OF LITERATURE REVIEW: MRI is the first imaging modality that visualizes the extent of spinal cord derangement directly and it has the potential to provide an accurate diagnosis and prognosis. MATERIALS AND METHODS: From March 1998 to September 2006, 39 patients who were eligible for a follow up of more than 1 year with an unstable burst fracture on the thoracolumbar region were studied. With these cases, The size of the bone fragment at the initial injury, signal change area on MRI, time to surgery, reduction rate of the bone fragments, recovery of the posterior curvature of the vertebrae and height of the vertebral body were analyzed. RESULTS: The mean fracture size rate, average time to surgery, reduction rate of bone fragment and the recovery rate of the height of the vertebral body was 46.1+/-12.8%, 17+/-4.5 hours, 35.2+/-10.1%, and 57.9+/-17.4%, respectively. The data shows that the time elapsed until surgery had no relationship with the prognosis (P=0.317). Injuries with broad signal changes on MRI were not associated with the reduction rate of bone fragments, recovery of posterior curvature of the vertebrae and the height of the vertebral body. CONCLUSIONS: In unstable burst fractures of the thoracolumbar region, although a comparison of the prognostic factors on simple X-ray film had no significance, it still has significant meaning when correlated with the signals on MRI.
Follow-Up Studies ; Humans ; Prognosis ; Retrospective Studies ; Spinal Cord ; Spine ; X-Ray Film

Curcumin is a widely used flavoring agent in food, and it has been reported to inhibit cell growth, to induce apoptosis, and to have antitumor activity in many cancers. Cisplatin is one of the most potent known anticancer agents and shows significant clinical activity against a variety of solid tumors. This study was undertaken to investigate the synergistic apoptotic effects of co-treatment with curcumin and cisplatin on human tongue SCC25 cells. To investigate whether the co-treatment efficiently reduced the viability of the SCC25 cells compared with the two treatments separately, an MTT assay was conducted. The induction and the augmentation of apoptosis were confirmed by DNA electrophoresis, Hoechst staining, and an analysis of DNA hypoploidy. Western blot, MMP and immunofluorescence tests were also performed to evaluate the expression levels and the translocation of apoptosis-related proteins following the co-treatment. In this study, following the co-treatment with curcumin and cisplatin, the SCC25 cells showed several forms of apoptotic manifestation, such as nuclear condensation, DNA fragmentation, reduction of MMP, increased levels of Bax, decreased levels of Bcl-2, and decreased DNA content. In addition, they showed a release of cytochrome c into the cytosol, translocation of AIF and DFF40 (CAD) to the nuclei, and activation of caspase-7, caspase-3, PARP, and DFF45 (ICAD). In contrast, separate treatments of 5 microM of curcumin or 4 microg/ml of cisplatin, for 24 hours, did not induce apoptosis. Therefore, our data suggest that combination therapy with curcumin and cisplatin could be considered as a novel therapeutic strategy for human oral squamous cell carcinoma.
Antineoplastic Agents ; Apoptosis ; Blotting, Western ; Carcinoma, Squamous Cell* ; Caspase 3 ; Caspase 7 ; Cell Line* ; Cisplatin* ; Curcumin* ; Cytochromes c ; Cytosol ; DNA ; DNA Fragmentation ; Electrophoresis ; Flavoring Agents ; Fluorescent Antibody Technique ; Humans ; Tongue*

Interleukin (IL)-4 inhibits proliferation of several human cancer cell lines in vitro. Although IL-4 is known to regulate proliferation of lymphocytes by modulating p27KIP1 expression, the mechanism involved in the IL-4-induced growth inhibition of nonhematopoietic cancer cells has not been fully elucidated. Previously, we reported that IL-4 suppressed proliferation of human renal cell carcinoma (RCC) cell lines in vitro. Here, we show that IL-4 inhibits cell cycle progression at the G1 phase in Caki-1 cells by increasing the expression of p21WAF1 and interferon regulatory factor (IRF)-1, and decreasing the cyclin dependent kinase (CDK) 2 activity. Up-regulation of p21WAF1 and IRF-1 expression is transcriptional, but independent of p53. The levels of p21WAF1 and IRF-1 proteins were enhanced as early as 1 h after IL-4 treatment. CDK2 activity started to decline at 4 h after IL-4 treatment, and by 24 h, was ~50% of the control. Neither the protein expressions of p27KIP1 and p16INK4a, nor the phosphorylation level of pRb was changed. The importance of p21WAF1 and IRF-1 in the growth inhibition induced by IL-4 was confirmed by antisense oligonucleotide transfection. Both of p21WAF1 and IRF-1 antisense oligonucleotides prevented IL-4-mediated growth inhibition by ~30% compared to the respective sense oligonucleotides. In summary, our study indicated that p21WAF1 and IRF-1 mediate the growth inhibitory effect of IL-4 in human RCC cells.
CDC2-CDC28 Kinases/metabolism ; Carcinoma, Renal Cell/genetics/*metabolism ; Cell Cycle/drug effects ; Cell Cycle Proteins/genetics/*metabolism ; Cell Line, Tumor ; Cell Proliferation/drug effects ; DNA-Binding Proteins/genetics/*metabolism ; Gene Expression/drug effects ; Humans ; Interleukin-4/*pharmacology ; Kidney Neoplasms/genetics/*metabolism ; Oligonucleotides, Antisense/genetics ; Phosphoproteins/genetics/*metabolism ; Research Support, Non-U.S. Gov't