The treatment of choice for Cushing's disease is surgical removal of tumor, the source of ACTH overproduction. In occasional patients in whom a surgical approach including total adrenalectomy is not feasible or surgical removal of tumor is not complete, medical treatment may be necessary because pituitary irradiation requires a long 1ag time to remission. Although ketoconazole, an imidazole derivative with inhibitory activity on adrenal steroidogenesis has been reported to be effective in the treatment of Cushing's disease, the limited effectiveness in lowering very high level of cortisol and occasional hepatotoxicity restrains its wide use. In this report, we describe a woman with Cushing's disease due to pituitary microadenoma. Transsphenoidal pituitary adenomeetomy followed by ketoconzole treatment had been unsuccessful in achieving remission of the disease, but combined treatment with ketoconazole and octreotide accomplished successful reduction in cortisol production.
Adrenalectomy ; Adrenocorticotropic Hormone ; Female ; Humans ; Hydrocortisone ; Ketoconazole* ; Octreotide* ; Pituitary Irradiation

To measure the mutagenic activity of micro-organic pollutants in drinking water, mutagenic test was conducted using Salmnella typhimurium TA 98 strain on the water sample taken from three water supply station and six tap water in Seoul in July and November 1987. The results were as follows : 1. The average amounts of organic matters in raw, treated, and tap water sampled in July were 0.38mg/l, 0.28mg/l, and 0.45mg/l, respectively, and sampled in November were 0.34mg/l, 0.24mg/l, and 0.22mg/l, respectively. The amount of organic matters of tap water sampled in November did not increase while that of tap water sampled in July increased compare to those of raw or treated water. 2. The amount of organic matters is the highest in neutral fraction compare to acidic and basic fractions. 3. In the five out of six tap water and raw water of Paldang and Kuui station sampled in July, the mutagenic ratios were greater than two (both direct and indirect mutagenicity). 4. In the three out six tap water and raw and treated water of Kuui station sampled in November, the mutagenic ratios were greater than two. 5. While mutagenic were low in acidic and basic fraction, they were high in neutral fraction. The samples which had high mutagenic activity in the total amount also showed high mutagenic activity in neutral fraction. 6. While mutagenic activity was decreased after the treatment of water, it was increased in tap water as the distance from the water supply station increases.
Drinking Water* ; Drinking* ; Seoul* ; Water ; Water Supply

OBJECTIVES: Serious mental illnesses and substance use disorder have a high level of early mortality. This study aimed to identify the causes of their deaths among patients who had been under the care of community mental health and welfare centers and addiction management centers.METHODS: We collected information on deceased individuals, whose mortality was attributable to various causes of death, from 10 Community Mental Health Centers and Addiction Centers in Gwangju Metropolitan City. The primary variables collected included psychiatric diagnosis, cause of death, smoking habits, admission history, and several socio-demographic factors.RESULTS: A total of 214 deaths among service users were studies. In Community Mental Health Centers, 109 deaths were identified, with causes that may be itemized as follows : 27 suicides(24.8%), 56 physical illnesses( 51.4%), 14 accidents(12.8%), and 12 unknown causes(11.0%). Among the physical illnesses reported, cardiovascular illness and cancer were the most common causes of death. A history of frequent admission was common among those that had died by suicide(88.9%), compared with that observed among general service users(62.0%). In Addiction Centers, 105 deaths were identified, with causes that may be itemized as follows : 7 suicides(6.7%), 71 physical illnesses(68.3%), 7 accidents(6.7%), and 20 unknown causes(19.0%). Among the physical illnesses reported, sudden death, hepatic disorder, cancer, and cardiovascular disorder were the most common causes of death.CONCLUSION: Case managers should give due consideration to and carefully manage the physical health of individuals accessing mental health services via community mental health centers and addiction centers.
Case Management ; Cause of Death ; Community Mental Health Centers ; Death, Sudden ; Gwangju ; Humans ; Mental Disorders ; Mental Health Services ; Mental Health ; Mortality ; Smoke ; Smoking ; Substance-Related Disorders ; Suicide

BACKGROUND: Among the various factors affecting bone mass and bone metabolism, aging and menopause play a major role. After the disappearance of the menstrual cycle, estrogen deficiency is the most important factor in bone loss. It is still unclear whether women with early menopause have a rate of bone loss different from women whose menopause has occurred later. Various biochemical bone markers are increased after menopause but it is still unclear whether women with early menopause have biochemical bone markers different from women whose menopause has occurred later. The aim of this study was to establish whether healthy women with early or normal menopause have different bone mass, biochemical bone markers and rates of bone loss. METHODS: Postmenopausal healthy women were divided into two groups according to their age at menopause(AAM): one group with AAM > 43 years, and the other group with AAM 50 years. Bone mass was measured using a dual energy X-ray absorptiometry(DEXA) in the lumbar, femur neck, femur trochanter, and Wards triangle. Serum levels of bone alkaline phosphatase and osteocalcin, and urine levels of calcium, deoxypyridinoline and type I collagen N-telopeptide were measured using a commercial kit. RESULTS: Age and body mass index in the early menopause group were different from those in the normal menopause group. All the bone mass and the biochemical bone markers in the early menopause group were not different from those in the normal menopause group. We selected 15 subjects from the two groups matched by age and BML Bone mass of femur neck in the early menopause group was lower than in the normal menopause group matched by age and BMI. Bone mass in lumbar, femur trochanter, and Wards triangle was lower in the early menopause group than in the normal menopause group, but the difference between the two groups was not significant. After adjusting years since menopause, we didnt find the difference of bone mass between the two groups. All the bone biochemical markers were not different in the two groups matched by age and BMI. CONCLUSION: Our data suggest that women with early menopause dont lose bone faster than women with normal menopause.
Aging ; Alkaline Phosphatase ; Biomarkers ; Body Mass Index ; Bone Density* ; Calcium ; Collagen Type I ; Estrogens ; Female ; Femur ; Femur Neck ; Humans ; Menopause* ; Menstrual Cycle ; Metabolism ; Osteocalcin

SV40 large T antigen, a viral oncoprotein, is known to immortalize human diploid fibroblast by soaking up cellular RB and p53, but its frequency is extremely low. Additional genetic alteration is necessary for single-step immortalization. We attempted to find out what this alteration is by overexpressing cellular signal mediator genes; c-myc and cyclin D frequently amplified in many cancer cells. Overexpression of cyclin D did not affect the immortalization, but, overexpression of c-myc along with T antigen could immortalize normal human diploid fibroblast. Several cellular markers tested during immortalization process showed that p21, a cyclin-dependent kinase inhibitor and a marker of cellular senescence, disappeared in the life span-extended cells by T antigen and in the immortalized cells by c-myc. p21 was, however, elevated in the senescent cells and in the cells of crisis. Interestingly, p16 was upregulated whenever T antigen is overexpressed. Telomerase activity was also activated only in the immortalized cells. These results suggest that overexpression of c-myc contributes to immortalization of human diploid fibroblast by activating telomerase activity and suppressing p21 activity.
Antigens, Polyomavirus Transforming/genetics/*metabolism ; Biological Markers ; Cell Aging/*genetics ; Cell Transformation, Viral ; Cells, Cultured ; Cyclins/metabolism ; Diploidy ; Fibroblasts/*metabolism ; Genes, myc/*genetics ; Human ; Protein p16/metabolism ; Simian virus 40/genetics ; Support, Non-U.S. Gov't ; Telomerase/metabolism

SV40 large T antigen, a viral oncoprotein, is known to immortalize human diploid fibroblast by soaking up cellular RB and p53, but its frequency is extremely low. Additional genetic alteration is necessary for single-step immortalization. We attempted to find out what this alteration is by overexpressing cellular signal mediator genes; c-myc and cyclin D frequently amplified in many cancer cells. Overexpression of cyclin D did not affect the immortalization, but, overexpression of c-myc along with T antigen could immortalize normal human diploid fibroblast. Several cellular markers tested during immortalization process showed that p21, a cyclin-dependent kinase inhibitor and a marker of cellular senescence, disappeared in the life span-extended cells by T antigen and in the immortalized cells by c-myc. p21 was, however, elevated in the senescent cells and in the cells of crisis. Interestingly, p16 was upregulated whenever T antigen is overexpressed. Telomerase activity was also activated only in the immortalized cells. These results suggest that overexpression of c-myc contributes to immortalization of human diploid fibroblast by activating telomerase activity and suppressing p21 activity.
Antigens, Polyomavirus Transforming/genetics/*metabolism ; Biological Markers ; Cell Aging/*genetics ; Cell Transformation, Viral ; Cells, Cultured ; Cyclins/metabolism ; Diploidy ; Fibroblasts/*metabolism ; Genes, myc/*genetics ; Human ; Protein p16/metabolism ; Simian virus 40/genetics ; Support, Non-U.S. Gov't ; Telomerase/metabolism

PURPOSE: Leptin has been considered a link between metabolic state and reproductive activity. Defective reproductive function can occur in leptin-deficient and leptin-excessive conditions. The aim of this study was to examine the effects of centrally injected leptin on the hypothalamic KiSS-1 system in relation to gonadotropin-releasing hormone (GnRH) action in the initial stage of puberty. METHODS: Leptin (1 microg) was injected directly into the ventricle of pubertal female mice. The resultant gene expressions of hypothalamic GnRH and KiSS-1 and pituitary LH, 2 and 4 hours after injection, were compared with those of saline-injected control mice. The changes in the gene expressions after blocking the GnRH action were also analyzed. RESULTS: The basal expression levels of KiSS-1, GnRH, and LH were significantly higher in the pubertal mice than in the prepubertal mice. The 1-microg leptin dose significantly decreased the mRNA expression levels of KiSS-1, GnRH, and LH in the pubertal mice. A GnRH antagonist significantly increased the KiSS-1 and GnRH mRNA expression levels, and the additional leptin injection decreased the gene expression levels compared with those in the control group. CONCLUSION: The excess leptin might have suppressed the central reproductive axis in the pubertal mice by inhibiting the KiSS-1 expression, and this mechanism is independent of the GnRH-LH-estradiol feedback loop.
Aluminum Hydroxide ; Animals ; Axis, Cervical Vertebra ; Carbonates ; Female ; Gene Expression ; Gonadotropin-Releasing Hormone ; Humans ; Leptin ; Luteinizing Hormone ; Mice ; Puberty ; RNA, Messenger

PURPOSE: Burn injury cause pruritis, pain, psychological and functional sequelae. The one of burn injury sequelae is the hypertrophic scar. It is difficult to control devastating fibrotic condition for hypertrophic scar. The objective of this study was to investigated the therapeutic effect on burn hypertrophic scar and wound healing for sequelae of burn injury by Porcine placenta extract (PPE). METHODS: To investigate the effect of PPE, we performed in vitro cell cytotoxity test (MTT assay), antioxidant activity assay (SOD like activity), melanin content assay, cell migration asssay and RT-PCR. RESULTS: As a result of cell cytotoxity test (MTT assay), PPE showed above 80% cell viability. From Antioxidant activity assay (SOD like activity), this effect was similar to vitamin C. In the melanin content assay, melanin synthesis was inhibited 23% on PPE treatment than control. PPE enhanced cell migration on human fibroblast and decreased the expression of hypertropic scar related gene (a-SMA and P311). CONCLUSION: Our data showed anti-oxidant effect, diminution of melanin and decrease of the expression of hypertropic scar related gene on the treatment of PPE. These results may provide the insight into the potential use of porcine placenta extract as support to control skin fibrosis related to burn hypertrophic scar and alternative medicine for burn sequelae.
Antioxidants ; Ascorbic Acid ; Burns ; Cell Migration Assays ; Cell Movement ; Cell Survival ; Cicatrix ; Cicatrix, Hypertrophic ; Complementary Therapies ; Fibroblasts ; Fibrosis ; Humans ; Melanins ; Placenta ; Pruritus ; Skin ; Wound Healing

No abstract available.

No abstract available.
Hyperhidrosis* ; Thoracotomy*