BACKGROUND: The vascular endothelial growth factor (VEGF) is known as a potent mediator of brain tumor angio-genesis, vascular permeablity, and glioma growth. This study was designed to study the balance between growth and death signals in different grades of astrocytic tumors. METHODS: Using immunohistochemistry, the relationship between the expression of VEGF and microvessel count and density were evaluated in 62 cases of astrocytic tumors including 33 low grade astrocytomas, 6 anaplastic astrocytomas, and 23 glioblastomas. In order to determine the apoptotic index (AI), the in situ end-labeling method was applied. RESULTS: VEGF was expressed on the tumor cell cytoplasm. Of 62 tumors, 44 (77%) were weak to strong postive for VEGF, but 18 cases were not reactive. VEGF positivity was correlat-ed with WHO grades of the astrocytic tumors; low grade astrocytomas (52%), anaplastic astrocytomas (83%), and glioblastomas (96%). Mean microvessel count and density were significantly higher in VEGF-positive tumors (75.7 and 4.1%) than in VEGF-negative tumors (43.9 and 2.5%). Apoptotic cells were readily found in the astrocytic tumors; the highest value of AI was observed in glioblastomas (8.6%) and the lowest in anaplastic astrocytomas (1.9%). It seemed that the grade of malignancy was not related with AI values. CONCLUSIONS: These results suggest that VEGF promotes angiogenesis with tumor cell growth against apoptotic cell death in the human astrocytomas.
Apoptosis* ; Astrocytoma ; Brain Neoplasms ; Cell Death ; Cytoplasm ; Glioblastoma ; Glioma ; Humans ; Immunohistochemistry ; Microvessels ; Vascular Endothelial Growth Factor A*

To investigate the effect of lidocaine on the intraocular pleasure during induction of general anestheaia, intraocular pressure (lOP) was measured together with mean arterial pressure (MAP) , pulse rate, before and after intratraoheal intubation under several condit-ions (saline 5cc, lidocaine, 2 mg/kfr, lidocaine 2 mg/kg plus succinlrcholine 1 mg/kg). The results were as follows 1) Changes in mean arterial Preesure was not significantly different between lidocaine-treated group and non-treated group (p <0.05), 2) Changes in pluse rate was also not significantly different between lidocaine-treated group and non-treated group (p<0.05). 3) A decrease in lOP was net statistically significant after either lidocaine or saline administration comparing with the control baseline level. 4) lOP was markedly increased above the control baseline level after succinylcholine (S.C.C.) administration.5) A increase in lOP produced by intratracheal intubation wart reduced significantly by pretreatment with lidocaine comparing with non-treated group (P<0.01). 6) Simultaneous administration of lidocaine and succinylcholine did not prevent increase in lOP produced by intratracheal incubation. The abode data suggest that it would be most preferable to intuhate the patients under the general anesthesia with lidocaine pretreatment without using succinlycholine in the patients with eye hall Perforation or the patients who have recent surgical ocular incision.
Anesthesia, General ; Arterial Pressure ; Heart Rate ; Humans ; Intraocular Pressure ; Intubation* ; Intubation, Intratracheal ; Lidocaine ; Pleasure ; Succinylcholine ; Warts

Exogenously added gangliosides modulate the growth and differentiation of a variety of cells in vitro including human gliomas. GM1, Gdla and GTlb gangliosides inhibit both PDGF-stimulated and serum-stimulated DNA synthesis of Swiss 3T3 cells and U1242 MG cells in a dose responsive manner. The inhibitory effect is counteracted in a dose-responsive fashion by serum, and that ganglioside-induced inhibition is essentially abolished in 10% serum. Because of the potentially important role that gangliosides play in growth regulation of human gliomas, this phenomenon was studied in detail using the human glioma cell line U1242 MG. Low doses of serum stimulate DNA synthesis of U1242 MG cells which is inhibited in a dose-responsive fashion by ganglioside GMI. However, serum itself counteracts the inhibitory effect of ganglioside in a dose-responsive way. On the other hand GM,, Gdla and GTlb stimulate DNA synthesis in quiescent U1242 MG cells in both sparse and confluent conditions, indicating that ganglioside-stimulated DNA synthesis is dependent on the phase of cellular growth rather than celluar density. The growth stimulatory effect of the three gangliosides is more potent on quiescent, confluent cells than quiescent, sparse cells. Gangliosides stimulate radiolabeling of and 35% of nuclei with (3H) thymidine in quiescent, sparse and quiescent, confluent cells respectively. These results demonstrate that exogenously added gangliosides can have different effects on progression of human glioma cells, support of the bimodal behavior model of gangliosides. The effects are mainly related to cell cycle depending on the growth phase of the cells rather than the cell density.
Cell Count ; Cell Cycle ; Cell Line ; DNA* ; Gangliosides* ; Glioma* ; Hand ; Humans ; Swiss 3T3 Cells ; Thymidine

BACKGROUND: Steroid myopathy is an unexpected side effect to the prolonged therapeutic use of steroids. To treat steroid myopathy, the followings are recommended; reduction of the steroid dose, usage of a nonfluorinated steroid, and conversion to an alternate day regimen. As muscle loading is encouraged in maintaining normal muscle properties, it is also apparent that physical exercise may be useful in the prevention and treatment of steroid myopathy. METHOD: The experiment was designed to investigate the effects of exercise on steroid myopathy. Rats being treated with triamcinolone acetonide (TA) (5 mg/kg/day) for 7 days exercised on a treadmill (speed 20m/min, 30 min/day, 3 days/week) for 2 weeks. The extensor digitorum longus (EDL) and soleus were then examined histochemically and ultrastructurally. RESULTS: Rats treated with TA showed significant loss of body and muscle weight. In the TA treated group, cross-sectional areas of type II fibers of both EDL and soleus were decreased in comparison with the controls. Necrotic changes were found only in type II fibers of the soleus. Recovery from the weight loss with type II fiber atrophy was more pronounced in the exercise group than that of the sedentary group, but was not significant statistically. Ultrastructural abnormalities, that consisted of subsarcolemmal mitochondrial accumulation, mitochondrial vacuolation, increased number of mitochondria in autophagic vacuoles, and dilatation of sarcoplasmic reticulum, were seen in TA treated muscles. These injuries were significantly reduced by the exercise, however, complete recovery could not be seen. CONCLUSIONS: These results suggest that treadmill exercise for 2 weeks partially ameliorate steroid myopathy in.
Animals ; Atrophy ; Dilatation ; Exercise* ; Mitochondria ; Muscles ; Muscular Diseases* ; Rats ; Sarcoplasmic Reticulum ; Steroids ; Triamcinolone Acetonide ; Vacuoles ; Weight Loss

BACKGROUND: Recently, many studies have reported that university students have been suffering from stress because of their the uncertainty of their future and employment. Eating habits have often been considered as one of health-related behaviors that may be affected by life stress. The purpose of this study was to examine the association between stress and eating habits in university students. METHODS: A cross-sectional study was designed. The subjects were 282 university students which assessed their eating habits and stresses. The total numbs of students in the study 263. Eating habits were scored using a questionnaire consisting of three categories-regularity, balance, and preference. The stress was assessed by modified Korean version of BEPSI. RESULTS: The stress score was 2.4 and the total score of eating habits was 44.2. The regularity among the domains of eating habits was 14.1, the balance score was 16.1, and the preference was 14.0. In multiple regression after adjustment with confounding variables, stress had a negative relationship with eating habits. CONCLUSION: The relationship between stress and eating habits was statistically significant, especially in regularity and balance. It is important to know not only the health status, but also the factors associated with health such as stresses and eating habits in order to improve the health status of the university students. Further research needs to uncover causality and make a generalization.
Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Eating* ; Employment ; Generalization (Psychology) ; Humans ; Stress, Psychological ; Uncertainty ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to assess the validity of CAGE (cut down, annoyed, guilty feeling, eye-opener) for older adults in community METHODS: Randomly selected alcohol drinking 182 older adults over 65 years of age in Incheon-Chungu participated in this study. We assessed alcohol use disorder by Korean Composite International Diagnostic Interview (K-CIDI) and interviewed by CAGE. The CAGE questionnaire is a brief alcohol screening questionnaire that can be interviewer or self-administered. Sensitivity, specificity, positive predictive value and receiver operating characteristics (ROC) curve for CAGE scores of 1-4 for older adults over 65 years of age was calculated. RESULTS: The mean age of 182 people was 71.3 (+/-5.2) years old and the number of male and female was 142 (78.0%) and 40 (22.0%) respectively. In 239 alcohol drinking older adults, 182 (76.2%) people answered in CAGE and CIDI. Among 182 people, 58 was Alcohol Use Disorder (AUD) and 124 was non-AUD. There was no age and educational differences between 182 people (case group) and 57 people (exclusion group). The sensitivity and specificity for a cut-off score of two was 72.5% and 85.5% respectively. The calculation of area under curve (AUC) by Receiver Operating Characteristics (ROC) was 0.806. CONCLUSION: The CAGE can easily discriminate older adults with alcohol use disorder from those without such a history. We suggest a score of '2' as the optimal cut-off score of CAGE.
Adult* ; Alcohol Drinking ; Area Under Curve ; Female ; Humans ; Male ; Mass Screening ; Surveys and Questionnaires ; ROC Curve ; Sensitivity and Specificity

PURPOSE: The purpose of this study is to evaluate the usefulness of MR imaging in the staging of brain abscesses and to determine the correlations between pathologic and MR findings. MATERIALS AND METHODS: Experimental brain abscesses were induced by direct inoculation of 1ml suspension of l06/ml Streptococcus pneumoniae into the brain parenchyma of ten New Zealand white rabbits. The evolution of abscess formation was divided into four stages, based on pathological criteria: early cerebritis (days 1 to 5), late cerebritis (days 6 to 10), early capsular (days 11 to 15), and late capsular (day 16 and later). The brain abscess of each animal was examined by MR imaging and light microscopy at 3, 8, 13, and 28 days; T1-weighted, T2-weighted and Gd-enhanced images were obtained. The MR images and pathologic findings of 13 pathologically confirmed clinical cases were compared to MR images of the experimental model. RESULTS: In the experimental model, signal intensity of the abscess content was at all stages hypointense on T1-weighted and hyperintense on T2-weighted images. In all ten cases, Gd-enhanced images showed an ill-defined contrast-enhanced lesion at the early cerebritis stage, and in four of seven cases, irregular ring enhancement at the late cerebritis stage. Pathologic specimens at this latter stage revealed prominent vascular proliferation and infiltration of chronic inflammatory cells. Signal intensity of the abscess wall during the capsular stage showed isointense relative brain parenchyma on T1-weighted images and this was hypointense on T2-weighted images. Gd-enhanced images demonstrated smooth ring enhancement of the abscess wall. At the early capsular stage, pathologic specimens revealed a discrete necrotic center surrounded by infiltration of reticulin and some collagen; at the late capsular stage, these specimens showed marked infiltration of collagen. In clinical cases, the signal intensity of abscess content was at all stages hypointenseon T1-weighted and hyperintense on T2-weighted images. Gd-enhanced images demonstrated ill-defined subtle contrast enhancement at the early cerebritis stage and irregular ring enhancement at the late cerebritis stage. In all cases, signal intensity of the abscess wall during the capsular stage was hypointense on T2-weighted images; at this stage, the abscess wall was showed a pattern of smooth ring enhancement. In clinical cases, hypointensity of the abscess wall, as seen on T2-weighted images, and the enhancement pattern of this wall were identical to these findings in the experimental model. CONCLUSION: In an experimental model, correlation between sequential MR findings can be used to predict the stage of a brain abscess; in clinical cases essential indicators are hypointensity and enhancement pattern of the abscess wall, as seen on T2-weighted images. In cases of brain abscess, MRI is a useful diagnostic modality, and in such cases, also helps determine the most suitable treatment.
Abscess ; Animals ; Brain Abscess* ; Brain* ; Collagen ; Magnetic Resonance Imaging* ; Microscopy ; Models, Theoretical* ; Rabbits ; Reticulin ; Streptococcus pneumoniae

PURPOSE: VEGF-C and VEGF-D are angiogenetic factors, and abnormal expression of E-cadherin hasa role in the progression of gastric carcinoma. The aim of this study was to evaluate the relationship between the expression of E-cadherin, VEGF-C and VEGF-D with the presence of lymph node metastases (LNM) using cytokeratin 18 in early gastric cancer (EGC). MATERIALS AND METHODS: Immunohistochemical staining for E-cadherin, VEGF-C and VEGF-D was performed in 49 EGC patients from March 1997 to December 2002. To evaluate the real extent of LNM, 1,562 lymph nodes from 49 patients were re-examined with the use of cytokeratin 18. RESULTS: Eleven (0.7%) LNM were newly found in 12.2% (n=6) of patients. The real LNM rate was 3.6% in mucosal invasive (m) cancer and 38.1% in submucosal invasive (sm). Stage migration was seen in three patients (6.1%). Abnormal expression of E-cadherin was detected in 36.7% of the patients and expression of VEGF-C and VEGF-D was detected in 16.3% and 36.7% of the patients, respectively. Abnormal expression of E-cadherin was significantly correlated with tumor differentiation (P=0.0103) and Lauren classification (P<0.0001). There was no positive relationship of VEGF-C and VEGF-D expression with the clinicopathological findings for EGC including LNM. However, the frequency of lymph node metastases was significantly higher in patients that demonstrated abnormal expression of E-cadherin with positive immunoreactivity of VEGF-C or VEGF-D (P=0.031). CONCLUSION: In present study, we could not demonstrate a relationship between the presence of LNM and expression of VEGF-C and VEGF-D in EGC. However, VEGF-C or VEGF-D expression, in addition to the abnormal expression of E-cadherin, was correlated with the real extent of LNM in EGC.
Cadherins ; Humans ; Keratin-18 ; Keratins ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms ; Vascular Endothelial Growth Factor C ; Vascular Endothelial Growth Factor D

Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.
Abdominal Cavity ; Abdominal Pain ; Adult ; Ascites ; Bile ; Bile Ducts ; Biliary Tract ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Contrast Media ; Drainage ; Early Diagnosis ; Humans ; Male ; Middle Aged ; Peritoneal Cavity ; Peritonitis ; Self Expandable Metallic Stents ; Sphincterotomy, Endoscopic ; Stents*

Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.
Abdominal Cavity ; Abdominal Pain ; Adult ; Ascites ; Bile ; Bile Ducts ; Biliary Tract ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Contrast Media ; Drainage ; Early Diagnosis ; Humans ; Male ; Middle Aged ; Peritoneal Cavity ; Peritonitis ; Self Expandable Metallic Stents ; Sphincterotomy, Endoscopic ; Stents*