"It was reported that polymorphism of TNF alpha gene was present in promoter region and involves the substitution of guanine by adenosine in the uncommon (TNFA 2) allele. In this study, we investigated the significance of TNFA gene polymorphism in relation to various clinical characteristics and autoantibody profiles in SLE as well as comparing it with that of other countries, and also studied its association with peripheral TNF-a production in vitro. TNFA genotyping was performed in 126 SLE patients and 300 controls using DNA extracted from peripheral leucocytes. The biallelic polymorphism at position -308 of the TNFA promotor was determined by Ncol- RFLP. Peripheral mononuclear cell production of TNF-a was investigated by bioassay using L-929 cell cytotoxicity. The TNFA ""1 homozygote was a predominant allele (77.0%) in SLE, which was not different from the controls. TNFA ""2 homozygate was extremely rare in both patients and controls (0.8%, 1.3% respectively). The clinical manifestations between TNFA '1 and TNFA""2 did not differ. The production of autoantibodies including dsDNA, anti-La, anti-nRNP and anti-Sm was not different between two alleles, whereas anti- Ro antibody was more frequent in TNFA""1/TNFA '1 than in TNFA'1/TNFA'2 (62.1% vs 38.4%, P=0.022). The polymorphism of TNFA gene did not influence the lipopolysaccharide stimulated peripheral mononuclear cell production of TNF-a (1356+/-293 vs 1119+/-385 pg/ml; TNFA'1/TNFA'1, TNFA'1/TNFA'2 respectively). These results suggested that promoter polymorphism of TNFA was not directly involved in the susceptibility of SLE and was not responsible for differential peripheral TNF-a production, but TNFA ' may be associated with anti-Ro antibody production."
Adenosine ; Alleles ; Autoantibodies ; Biological Assay ; DNA ; Guanine ; Homozygote ; Humans ; Lupus Erythematosus, Systemic* ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; Tumor Necrosis Factor-alpha*

Obesity is one of the well-known risk factors of breast cancer. We evaluated the relationship between serum adiponectin and resistin levels and breast cancer risk in 41 biopsy-proven breast cancer patients and 43 age- and body mass index-matched controls. The mean serum adiponectin level was lower in the breast cancer group than the control group (6.93+/-3.2 microgram/mL, vs. 7.60+/-3.5 microgram/mL), but this difference did not reach statistical significance (p=0.37). There was a statistically significant difference in serum resistin levels between the groups (breast cancer group 5.23+/-6.9 ng/mL vs. control 1.46+/-2.0 ng/mL; p<0.001). The risk of breast cancer was significantly increased in the highest tertile group for serum resistin level compared to the lowest tertile group (adjusted odds ratio 2.77 [95% CI 1.40-5.50]). The lymph node metastasis was significantly increased in the patients with less than the median adiponectin level (p=0.017). In the patients whose resistin level was higher than the median, the frequency of tumor with the highest histological grade was significantly increased (p=0.025). In conclusions, both the low serum adiponectin levels and high resistin levels are likely to be associated with increased breast cancer risk in Korean women.
Resistin/*blood ; Odds Ratio ; Middle Aged ; Insulin Resistance ; Humans ; Female ; Case-Control Studies ; Breast Neoplasms/*blood/etiology/pathology ; Adult ; Adiponectin/*blood

The fourth author's name was misprinted.
Fibroblast Growth Factor 2* ; Humans ; Pilot Projects*

The genitourinary syndrome of menopause (GSM) is a new term that describes various menopausal symptoms and signs including not only genital symptoms (dryness, burning, and irritation), and sexual symptoms (lack of lubrication, discomfort or pain, and impaired function, but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections). The terms vulvovaginal atrophy and atrophic vaginitis, which were generally used until recently, had a limitation because they did not cover the full spectrum of symptoms and did not imply that the symptoms are related to a decreased estrogen level in menopause. Since the GSM may have a profound negative impact on the quality of life of postmenopausal women, women should be made aware of these problems and treated with an appropriate effective therapy. Thus, in this review we introduce new terminology and discuss the importance of comprehension of GSM and the necessity of active treatment of this syndrome in postmenopausal women.
Atrophic Vaginitis ; Atrophy ; Burns ; Comprehension ; Dysuria ; Estrogens ; Female ; Humans ; Lubrication ; Menopause* ; Quality of Life ; Urinary Tract

BACKGROUND: Identification of the genes expressed differentially in renal cell carcinoma (RCC)but not in the non-cancerous kidney is important for understanding the molecular basis ofrenal cell carcinoma and for defining possible prognostic value and therapeutic intervention.We investigated the changes in gene expression accompanying the development and progression of kidney cancer by cDNA microarrays. METHODS: To identify molecular alterations in renal cell carcinoma, we measured expression profiles for paired neoplastic and noncancerouskidney samples from an individual by means of a cDNA microarry representing 7, 500genes. Of the differentially expressed genes, we assessed the decorin gene at the proteinlevel using immunohistochemistry. RESULTS: The 60 genes were noted to have more than a fivefold change in expression (either increased or decreased) in RCC compared to the noncancerouskidney. The changed genes are those associated with signal transduction, metabolizingenzymes, the cytoskeleton, cell adhesion, cell cycle control, modulation of transcription, the tumor suppressor gene and tumor antigens. Under immunohistochemistry, the expressionof decorin was significantly decreased in the tumor than in the non-cancerous kidney.The expression rate of decorin was not associated with the patient's sex, age, histologic type, Fuhrmann nuclear grade and T stage. CONCLUSION: The author predicted that these geneexpression profiling experiments will lead to improvements in the basic understanding of renaltumor pathogenesis and will promote the discovery of novel molecular markers for renal tumordiagnosis and therapy.
Antigens, Neoplasm ; Carcinoma, Renal Cell* ; Cell Adhesion ; Cell Cycle Checkpoints ; Cytoskeleton ; Decorin* ; DNA, Complementary* ; Gene Expression* ; Genes, Tumor Suppressor ; Immunohistochemistry ; Kidney ; Kidney Neoplasms ; Oligonucleotide Array Sequence Analysis* ; Signal Transduction

Aplastic anemia is a rare side-effect associated with ticlopidine therapy. We report one case of severe aplastic anemia developed after the use of ticlopidine. A 72-year-old woman took ticlopidine at 500 mg/day to prevent a secondary stroke. Forty days after starting ticlopidine, she developed general weakness and nausea. She showed pancytopenia and was diagnosed as aplastic anemia, confirmed by bone marrow examination. Twelve days after the withdrwal of ticlopidine, the hematologic parameters improved. Physicians are reminded that complete blood cell counts and white blood cell count differentials should be monitored every 2 weeks in ticlopidine users during the first 3 months of treatment.
Aged ; Anemia, Aplastic* ; Blood Cell Count ; Bone Marrow Examination ; Female ; Humans ; Leukocyte Count ; Nausea ; Pancytopenia ; Stroke ; Ticlopidine*

Primary non-Hodgkin' lymphomas of the liver, an organ normally devoid of a native lymphoid tissue, are very rare. We recently experienced a case of a primary low-grade hepatic B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type in a 36-year-old woman. The ultrasonography revealed a 5 cm sized mass in the right lobe of the liver. A right segmentectomy of the liver was done and showed a relatively well-circumscribed brownish yellow lobulated homogenous mass, measuring 5.5x4.5 cm in size. Histologic sections of liver mass revealed large lymphoid follicles with reactive germinal centers, follicular colonization by centrocyte-like cells (CCL cells), and lymphoepithelial lesions. The CCL cells were positive for B-cell (CD20), LCA (CD45RA), Bcl-2 oncoprotein, and lambda light chain.
Adult ; B-Lymphocytes ; Colon ; Female ; Germinal Center ; Humans ; Liver* ; Lymphoid Tissue ; Lymphoma* ; Lymphoma, B-Cell ; Mastectomy, Segmental ; Ultrasonography

We first report a case that demonstrates superi-mposed acute renal failure associated with rhabdo-myolysis in a patient with tsutsugamushi disease. The clinical presentation was that of insidious onset of fever, abdominal pain, back pain, renal failure and respiratory failure over about 20 days period. The renal function was progressively deteriorated and the serum creatinine concentration increased from 1.4 to 8.4mg/dL, while the patient was in a state of septic shock caused by tsutsugamushi disease. The laboratory data including increased muscle enzymes such as CK, LDH, SGOT, myoglobin, positive test for urine myoglobin, and increased uptake of bone scan were consistent with rhabdomyolysis. On consideration of the cause of rhabdomyolysis in this patient, endotoxin made in the state of septic shock had triggered a muscle necrosis and acute renal failure aggravated by dehydration and metabolic acidosis. She was recovered by the proper use of a IV doxycycline as the therapy of tsutsugamushi disease with a maintenance of renal blood flow by hydration, mannitol, bicarbonate and protection of hypotension. We suggest that rickettsial disease, especially tsutsugamushi disease can result in the acute renal failure by rhabdomyolysis.
Abdominal Pain ; Acidosis ; Acute Kidney Injury* ; Aspartate Aminotransferases ; Back Pain ; Creatinine ; Dehydration ; Doxycycline ; Fever ; Humans ; Hypotension ; Mannitol ; Myoglobin ; Necrosis ; Renal Circulation ; Renal Insufficiency ; Respiratory Insufficiency ; Rhabdomyolysis ; Scrub Typhus ; Shock, Septic

BACKGROUND: Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION: This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION: Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.
Dental Implants ; Dental Occlusion ; Displacement (Psychology) ; Esthetics ; Humans ; Mandible ; Mouth ; Mouth Rehabilitation ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus ; Tooth

PURPOSE: The incidence of secondary malignancies in hematologic patients is known to be higher than it is in other patients. However, the characteristics of secondary malignancy and surveillance have not yet been established for colorectal cancer in leukemic patients. METHODS: From 1995 to 2007, 6,030 patients who were diagnosed with acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML), chronic lymphoid leukemia (CLL), and multiple myeloma (MM) were enrolled in this study. Among them, 9 patients were diagnosed with colorectal cancer at St. Mary's Hospital and were analyzed retrospectively. RESULTS: Three of the 2,570 patients with AML, 1 of the 1,158 patients with CML, 2 of the 83 patients with CLL, 2 of the 422 patients with MM, and none of the 1,797 patients with ALL were found to have colorectal cancer. There were no operative mortalities, but 2 patients refused to have surgery. The ratio of observed to expected subsequent colorectal cancer in CLL was higher than it was in the other groups, indicating that the relative risk of colorectal cancer is higher in patients with CLL. CONCLUSION: Compared to the Surveillance, Epidemiology and End-Result (SEER) program at the National Cancer Institute (NCI) in the United State, we have the same high relatively risk in CLL patients. Careful attention should be paid to the possibility of colorectal cancer in CLL patients.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Hematologic Diseases ; Humans ; Incidence ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Multiple Myeloma ; National Cancer Institute (U.S.) ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies