Diabetes is accompanied by delayed wound healing and insufficient granulation tissue formation, possibly because of a defect in fibroblast function. Maintaining glucose level at acceptable low level is considered to be an important part of the clinical treatment of diabetes, but the exact mechanism by which diabetes delays wound repair is not yet known. This study was designed to evaluate the effects of glucose on proliferation([3H]-thymidine uptake) and collagen synthesis([3H]-proline uptake) in dermal fibroblasts from non-lesional skins and chronic wounds. The subjects were divided into 3 groups: non-diabetic control(n = 5), glucose controlled(glycated Hb < 7%) diabetics(n = 5), and glucose uncontrolled(glycosylated Hb > 8%) diabetics(n = 5). The fibroblasts were cultured in two conditions, low glucose(5 mM) and high glucose(20 mM) medium. The data were compared using Mann-Whitney test. The results are as follows: 1. There were no significant differences in the proliferation and collagen synthesis of non-lesional skin fibroblasts in all groups. 2. In high glucose medium culture, the proliferation of the fibroblasts from the wound of the glucose uncontrolled diabetic group was significantly lower than those of the other 2 groups(p< 0.05), and the collagen synthesis of the wound fibroblasts of the control group was significantly higher than those of 2 diabetic groups(p< 0.05). 3. The proliferation and collagen synthesis of the wound fibroblasts in all groups were significantly lower than those of the non-lesional skin fibroblasts(p< 0.05). 4. In the control group and the glucose controlled diabetic group, the proliferation of the wound fibroblasts in the high glucose culture media were lower than those in the low glucose culture media(p< 0.05). Also, in the glucose controlled diabetic group, the collagen synthesis of the wound fibroblasts in the high glucose culture medium was lower than that in the low glucose culture medium(p< 0.05). These results demonstrate that the glucose level may affect the proliferation and collagen synthesis of fibroblasts, and the strict blood glucose control is beneficial to the prevention and treatment of diabetic chronic wounds.
Blood Glucose ; Collagen* ; Culture Media ; DNA* ; Fibroblasts* ; Glucose* ; Granulation Tissue ; Skin ; Wound Healing ; Wounds and Injuries*

Deregulation of G1 cyclins has been reported in several human and rodent tumors including colon cancer. To investigate the expression pattern of G1 cyclins in 1,2- dimethyl-hydrazine dihydrochloride (DMH)-induced rat colon carcinogenesis, we studied the expression of cyclin D1 and cyclin E by quantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis and immunohistochemistry (IHC). The mRNA level of cyclin D1 was increased 1.2-fold in adenocarcinomas but not significantly in adenomas, when compared with normal rat colonic mucosa (p<0.05). The cyclin E mRNA level was increased 2.7-fold in adenomas and 3.3-fold in adenocarcinomas (p<0.05). The PCNA mRNA level was also increased 1.9-fold in adenomas and 1.8-fold in adenocarcinomas (p<0.05). Immunohistochemical staining revealed exclusive nuclear staining of the neoplastic cells for cyclin D1, cyclin E and PCNA. Cyclin D1 expression was detected in 56.3% of the adenomas and in 61.5% of the adenocarcinomas examined, whereas cyclin E expression was detected in 87.5% of the adenomas and in 92.3% of the adenocarcinomas. Overall, cyclin D1, cyclin E and PCNA expression was significantly increased at both the mRNA and protein levels in normal colonic mucosa, adenomas and adenocarcinomas, but there was no significant difference in the degree of expression of these genes in adenomas and adenocarcinomas. Our results indicate that the overexpression of cyclin D1 and cyclin E may play an important role during the multistage process of rat colon carcinogenesis, at a relatively early stage, and may disturb cell-cycle control in benign adenomas, and thereafter, participate in tumor progression.
1,2-Dimethylhydrazine/toxicity ; Adenocarcinoma/*chemically induced/metabolism ; Adenoma/*chemically induced/metabolism ; Animals ; Carcinogens/toxicity ; Cell Cycle/drug effects/physiology ; Colon/metabolism ; Colonic Neoplasms/*chemically induced/metabolism ; Cyclin D1/*biosynthesis/genetics ; Cyclin E/*biosynthesis/genetics ; Gene Expression Regulation, Neoplastic ; Immunohistochemistry ; Male ; Proliferating Cell Nuclear Antigen/biosynthesis/genetics ; RNA, Messenger/metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUND: Ventrlcular tachyarrhythmias are major cause of sudden cardiac death in patients after myocardial infarction and their accurate detection seems to be important in prevention of sudden cardiac death. Clinical findings, treasmill test, holter monitoring and coronary angiography have been used to search for high risk group in sudden cardiac death. Recently electrographysiologic stimulation has been to this, but it is not practical, because of high cost and invasiveness. Signal averaged electrocardiogram(SAECG) may be helpful in prediction of high risk group in sudden cardiac death. So we try to know the values of SAECG in Korean patients without heart disease. RESULTS: 1) The mean value and standard deviation of Time domain analysis is as follows ; fQRS : 106.8+/-12.3ms, RMS : 36.2+/-21.5(micro)V, LAS : 27.2+/-8.1ms. 2) The mean value and standard deviation of Spectral turbulence analysis is a follows ; LSCR : 58.6+/-3.9, ISCM : 95.2+/-0.8, ISCSD : 71.8+/-15.7, SE : 6.9+/-1.8. CONCLUSION: There was no significant difference between male and female. Time domain analysis shows significant differences among each hour but spectral turbulence analysis did not. Spectral turbulence analysis shows high specificity.
Coronary Angiography ; Death, Sudden, Cardiac ; Electrocardiography* ; Electrocardiography, Ambulatory ; Female ; Heart Diseases* ; Heart* ; Humans ; Male ; Myocardial Infarction ; Sensitivity and Specificity ; Tachycardia

OBJECTIVES: Power spectrum analysis decomposes the heart rate signal into its frequency components and facilitates separation of sympathetic (low frequency) and parasympathetic (high frequency) activity. In congestive heart failure, augmented sympathetic tone and decreased parasympathetic tone were found. Autonomic nervous system was normalized 6 months after myocardial infarction. So we compared the autonomic nervous system activity by the heart rate variability in congestive heart failure and old myocardial infarction. METHODS: The protocol involved 20 healthy subjects (Group 1), 5 congestive heart failure patients not caused by myocardial infarction (Group 2), 4 congestive heart failure patients due to myocardial infarction and 11 old myocardial infarction patients without heart failure. We took 24 hour Holter monitoring by Del Mar Avionic tape recorder. All Holter tapes were analyzed with use of Model 563 Stratascan Holter Analysis System. We computed power spectra on each 256 sec segment of each hour during 24 hour recording. So, RR interval, SD of RR interval by time domain, and LF, HF, LF/HF ratio, Total PSD by frequency domain were measured. RESULTS: In congestive heart failure, nocturnal HF peak and diurnal variation of LF/HF ratio was decreased relative to healthy subjects. Nocturnal HF peak in old myocardial infarction was not visualized. All of LF, HF and Total PSD in congestive heart failure and old myocardial infarction patients relative to healthy subjects. CONCLUSION: On heart rate variability analysis using by 24 hour Holter monitoring, abnormal autonomic nervous activity was demonstrated in congestive heart failure and old myocardial infarction patients relative to healthy subjects.
Autonomic Nervous System ; Electrocardiography, Ambulatory* ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Rate* ; Heart* ; Humans ; Myocardial Infarction* ; Spectrum Analysis

Toxocariasis is a helminozoonosis caused by the infection of a human host by the larva of Toxocara canis and Toxocara catis, which are common nematodes in dogs and cats, and occurs more frequently in school age children. Toxocariasis shows variable clinical manifestations including hepatomegaly, bronchial asthma, uveitis, central nervous system symptoms with peripheral eosinophilia and an increased total serum IgE level. However a hepatic abscess caused by toxocara infection in adults is rare. We experienced a case of heavy alcoholic patients with a hepatic eosinophilic abscess caused by toxocara infestation, which was confirmed by microscopic examination of liver biopsy, enzyme-linked immunosorbent assay test, abdominal CT and the ultrasonography findings.
Adult ; Animals ; Humans ; Liver Abscess/*diagnosis/*parasitology/ultrasonography ; Male ; Tomography, X-Ray Computed ; Toxocara canis/*isolation & purification ; Toxocariasis/*diagnosis/parasitology/pathology

Gastrointestinal lipomas are benign adipose tumors that are usually submucosal, and most commonly found in the colon. However, they have also been discovered in the small bowel, stomach and very rarely in the esophagus. Although most of gastrointestinal lipomas are asymptomatic and are found incidentally at time of endoscopy, surgery or autopsy, large lipomas can cause acute abdominal pain, bowel habit changes, gastrointestinal bleeding, intussusception or bowel obstruction. Lipomas can be diagnosed by colonoscopy, abdominal CT, barium series and endoscopic ultrasonography (EUS). Large lipomas need to be treated using various techniques. However, the best treatment modality for large lipomas has not yet been established. A surgical resection of lipomas should be considered for a giant lipoma >2 cm in diameter due to the risk of perforation or hemorrhage. Currently, endoscopic snare polypectomy or endo-loop ligation is used to treat symptomatic lipomas, which may reduce the risk of complications associated with endoscopic treatment. We report a case of giant colonic lipoma that was diagnosed successfully with EUS and treated safely using an endoscopic unroofing technique, endoloop ligation and snare polypectomy in phases.
Abdominal Pain ; Autopsy ; Barium ; Colon ; Colonoscopy ; Endoscopy ; Endosonography ; Esophagus ; Hemorrhage ; Intussusception ; Ligation ; Lipoma ; SNARE Proteins ; Stomach

Traditional symptom-based therapies of irritable bowel syndrome (IBS) are directed at the relief of individual IBS symptoms, but they are often of limited efficacy in addressing the entire symptom complex. Combinations of drugs to target bothersome symptoms are suggested as the first-line pharmacologic treatment. Increasing knowledge of the pathophysiology and molecular mechanisms of IBS has resulted in the development of several new therapeutic approaches. Thirteen consensus statements for the treatment of IBS were developed using the modified Delphi approach. Exclusion diets have modest efficacy in improving symptoms in some IBS patients. Symptom-based therapies with dietary fiber, bulking agents, laxatives, antispasmodics and laxatives are effective in the improvement of some individual symptoms, e.g. dietary fiber and bulking agents for constipation, laxatives for constipation, antispasmodics for abdominal pain and discomfort, antidiarrheals for diarrhea. 5HT3 receptor antagonists and 5HT4 receptor agonists are effective in the relief of global IBS symptoms and individual symptoms such as abdominal pain and abnormal bowel habits. A short term course of nonabsorbable antibiotics may improve global IBS symptoms, particularly in patients with diarrhea- predominant IBS. Some probiotics appear to have the potential benefit in improving global IBS symptoms. Selective C-2 chloride channel activator is more effective than placebo at relieving global IBS symptoms in patients with constipation-predominant IBS. Both tricyclic antidepressants and selective serotonin reuptake inhibitors are equally effective in relieving global IBS symptoms, and have some benefits in treating abdominal pain. Certain types of psychologic therapy may be effective in improving global symptoms in some IBS patients. Further studies are strongly needed to develop better treatment strategies for Korean patients with IBS.
Anti-Infective Agents/therapeutic use ; Antidepressive Agents/therapeutic use ; Antidiarrheals/therapeutic use ; Dietary Fiber/therapeutic use ; Humans ; Irritable Bowel Syndrome/*therapy ; Laxatives/therapeutic use ; Parasympatholytics/therapeutic use ; Probiotics/therapeutic use ; Serotonin 5-HT4 Receptor Agonists/therapeutic use ; Serotonin Antagonists/therapeutic use

BACKGROUND: Diphtheria epidemics in Russia have spread to all the other independent states of the former Soviet Union and East European countries around 1990s. One of the most important measures in preventing diphtheria is to maintain high levels of immunity in the population. We studied the diphtheria antibody levels of 1,086 participants to investigate herd immunity in Korea. METHODS: The tested 1,086 serum specimens were collected from healthy individuals from September 1995 to March 1996. Diphtheria antitoxin titers were measured by a micro cell culture method using Vero cells. Antibody titer of 0.01 IU/ml to neutralize diphtheria toxin is an internationally accepted protective level. RESULTS: We studied the diphtheria antitoxin titer levels of 1,086 cases consisting of 579 males and 507 females. The proportion of protective antitoxin level to diphtheria is 69.2%. Diphtheria antitoxin levels showed no significant difference between males and females. The highest seropositive rate was observed in the 5 to 9-year old age group(95.8%). The seropositivity rate declined with age. The lowest seropositive rate was observed in the 20~39 years of age, maximally 43.4 %. Over 40 years of age, the seropositive rates increased again. CONCLUSION: The antibody titers in the Korean population declined from 95.8% to below 50% with age in the 1~39 year-old age group. To maintain the rate of population with protective antibodies to diphtheria, we recommend Td booster immunization to adults with low antitoxin titers and continuous survey for antitoxin titers.
Adult ; Antibodies ; Cell Culture Techniques ; Child ; Diphtheria Antitoxin ; Diphtheria Toxin ; Diphtheria* ; Female ; Humans ; Immunity, Herd ; Immunization, Secondary ; Korea ; Male ; Russia ; USSR ; Vero Cells

Primary adenosquamous carcinoma of the liver is generally considered as an extremely rare subtype of cholangiocarcinoma. It has been reported mostly in a form of case studies. As far as we know, there was only one case report on tumor related with biliary fistula. Recently, we experienced a case of primary adenosquamous carcinoma of liver with a formation of tumor-colonic fistula. A 54-year-old man was transferred to our hospital due to liver mass detected by abdominal ultrasonogram. Dynamic computed tomogram of liver showed a large irregular hypodense mass without rim enhancement in right lobe of liver and also suggested a fistula formation between the tumor and hepatic flexure of right colon. Colonoscopic examination showed a large colonic wall defect in hepatic flexure and a friable, nodular mucosa around the defected colonic wall. Extended right lobectomy and right hemicolectomy were done. Microscopically, the tumor was composed of squamous cell carcinoma mainly with foci of the adenocarcinoma component.
Carcinoma, Adenosquamous/*pathology/radiography/surgery ; Colonic Diseases/*pathology ; Colonoscopy ; Humans ; Intestinal Fistula/*pathology ; Liver Neoplasms/*pathology/radiography/surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Cat-scratch disease (CSD), caused by Bartonella henselae is one of the most common zoonosis. However, only several cases of B. henselae infection have been reported in Korea. This study investigated the seroprevalence of B. henselae in healthy adults and related risk factors. METHODS: Serum samples from 300 healthy participants were analyzed using an immunoglobulin G immunof luorescence assay (IFA) for B. henselae isolated in Korea. Surveys on the risk factors for B. henselae infection were conducted simultaneously. RESULTS: Of the participants, 47.7% and 15.0% raised dogs and cats, respectively. The overall seroprevalence of B. henselae was 15.0% (IFA titer ≥ 1:64). Participants who had raised cats showed 22.2% seropositivity against B. henselae, and those with no experience with cats showed 13.7% seroprevalence (p = 0.17). Participants who had cats as pets or been scratched by cats, showed 9.8% seropositivity against B. henselae (IFA titer ≥ 1:256). However, those who had not raised or been scratched by a cat showed 2.0% seropositivity (p = 0.015). CONCLUSIONS: In Korea, the seroprevalence of B. henselae is higher than expected, suggesting that Bartonella infection due to B. henselae is not uncommon. Cats are proposed to play a more important role than dogs in transmission of CSD.
Adult* ; Animals ; Bartonella henselae* ; Bartonella Infections ; Bartonella* ; Cat-Scratch Disease ; Cats ; Dogs ; Healthy Volunteers ; Humans ; Immunoglobulin G ; Korea* ; Risk Factors ; Seroepidemiologic Studies*