No abstract available.
Acidosis, Renal Tubular* ; Captopril*

A twenty four-year-old female patient had suffered progressive dyspnea for 6 years until death. She denied any symptoms suggestive of connective tissue disease, or deep vein thrombosis. She suffered an episode of pontine infarct in 1995. Four years after diagnosis of primary pulmonary hypertension, she died of sudden death during hospitalization. Gross features of pulmonary arteries at autopsy were as follows: left main pulmonary artery showed dilation of the lumen and thickening of the wall, and right main pulmonary artery was markedly dilated and contained fresh thrombus. Hematoxylin and eosin-stained sections of lung tissue showed plexiform lesions of pulmonary arteries, complete luminal obliteration of pulmonary arterioles and dilated lesion of pulmonary arterioles, and capillaries. This patient represents a typical case with a primary pulmonary arteriopathy with plexiform lesions with thrombotic lesion, demonstrating the importance of thrombosis in situ in the pathogenesis of primary pulmonary hypertension. To our knowledge, this is the first autopsy report on the primary pulmonary hypertension in Korea.
Arterioles ; Autopsy ; Capillaries ; Connective Tissue Diseases ; Death, Sudden ; Diagnosis ; Dyspnea ; Female ; Hematoxylin ; Hospitalization ; Humans ; Hypertension, Pulmonary* ; Korea ; Lung ; Phenobarbital ; Pulmonary Artery ; Thrombosis ; Venous Thrombosis

PURPOSE: Recently, the role of vitamins, folate in particular, has been emphasized in the maintenance of health. Folate deficiency is known to give rise to developmental delay, pre-mature vascular disease, neural tube defects, acute leukemia, atherosclerotic vascular disease, delivery defects, breast cancers and gastrointestinal neoplasia. Methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme in folate metabolism, and influences DNA synthesis and DNA methylation. Generally, a low folate level is known to be associated with gastrointestinal neoplasms. Also, the amino- acid-changing and enzyme-activity-reducing nucleotide polymorphism (677C-->T/Ala222Val) has been described in the MTHFR polymorphism and it brings about low enzyme activity, which may reduce DNA methylation and uracil misincorporation into DNA. These processes may be critical for the oncogenic transformation of human cells. Two common single nucleotide polymorphisms (SNPs) resulting in amino-acid changes (677C T/Ala222Val and 1298A C/Glu428Ala) have been described in MTHFR. We investigated the relation between the MTHFR C677T and A1298C polymorphisms derived from colorectal cancers and from controls in the Korean population. METHODS: One hundred forty-eight (148) individuals with colorectal cancer and 288 healthy persons were analyzed. Blood sampling of each group was performed by using a PCR- RFLP analysis, and MTHFR polymorphism genotypes of 677C/C, 677C/T, 677T/T, 1298AA, 1298AC, and 1298CC were obtained. RESULTS: The genotype frequencies of MTHFR C677T polymorphisms were 25.0% (CC), 48.0% (CT), 27.0% (TT), and 75.0% (CT+TT), respectively, in case patients and 39.2% (CC), 36.8% (CT), 24.0% (TT), and 60.8% (CT+TT) in controls. The genotype frequencies of MTHFR A1298C polymorphisms were 56.1% (AA), 372% (AC), 6.8% (CC), and 43.9% (AC+CC), respectively, in case patients and 55.6% (AA), 40.3% (AC), 4.2% (CC), and 44.4% (AC+CC) in controls. The 677TT and the 677CT genotypes were associated with significantly increased risks for colorectal cancer (adjusted OR=1.77 and 95% CI=1.02~3.04 in TT; adjusted OR=2.07 and 95% CI=1.28~3.35 in CT) than was the 677CC, genotype but the the 1298CC and 1298 AC genotypes were not associated with significantly increased risks for colorectal cancer (adjusted OR=1.75 and 95% CI= 0.71~4.26 in CC; adjusted OR=0.95 and 95% CI=0.62~1.45 in AC). CONCLUSIONS: The MTHFR C677T polymorphism may be influenced by colorectal cancer, but the role of the MTHFR A1298C polymorphism needs careful interpretation and confirmation in larger studies.
Breast ; Colorectal Neoplasms* ; DNA ; DNA Methylation ; Folic Acid ; Gastrointestinal Neoplasms ; Genotype ; Humans ; Leukemia ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Neural Tube Defects ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Uracil ; Vascular Diseases ; Vitamins

PURPOSE: Urinary tract infection (UTI) in children is the most common disease during the infantile period, therefore early diagnosis and treatment are important. Pyuria is a useful clinical parameter for the initial diagnosis of a UTI. In this study we aimed to compare the clinical, laboratory, and imaging findings in relation to the duration of pyuria in infants with UTIs. METHODS: Three hundred seventy-four infants <12 months of age who were admitted between January 1995 and December 2005 for the first episode of a febrile UTI were retrospectively reviewed. Patients were divided into two groups according to the duration of pyuria as follows: group 1, pyuria resolved <3 days after initial treatment; and group 2, pyuria lasted at least 3 days after initial treatment. RESULTS: There were no significant differences between the two groups in relation to gender, age, total duration of fever, and organisms in the urine. Group 2 had a significantly higher peripheral blood leukocyte count (14,360.86+/-5,526.16 cells/mm3 vs. 11,822.55+/-5,687.26 cells/mm3, P<0.001), erythrocyte sedimentation rate (32.81+/-19.34 mm/hr vs. 23.74+/-20.43 mm/hr, P<0.001), and C-reactive protein (6.84+/-5.68 mg/dL vs. 3.78+/-3.99 mg/dL, P<0.001) than group 1. There was a significantly higher incidence of hydronephrosis and a higher grade of vesicoureteral reflux (VUR) in group 2 compared to group 1. CONCLUSION: In infants with UTI, pyuria of longer duration is related to severe UTI and higher grade VUR, therefore aggressive radiologic studies may be necessary.
Blood Sedimentation ; C-Reactive Protein ; Child ; Early Diagnosis ; Fever ; Humans ; Hydronephrosis ; Incidence ; Infant ; Leukocyte Count ; Pyuria ; Retrospective Studies ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

PURPOSE: Lymph node analysis is essential for staging gastric cancer. Intraoperative lymphatic mapping and sentinel lymphadenectomy have not yet been investigated for most gastrointestinal neoplasms. The purpose of this study is to evaluate the usefulness of ex vivo lymphatic mapping in patients with gastric cancer. METHODS: 42 patients with gastric cancer underwent ex vivo lymphatic mapping and sentinel lymph node (SN) biopsy after standard surgical resection from March 2002 to September 2002. Within 5 minutes of resection, stomach specimens were injected submucosally around the tumor with isosulfan blue dye. Blue lymphatic channels were identified and followed to the blue-stained SN (s) which were harvested. The specimen was fixed in formalin and subsequently analyzed in the usual fashion. RESULTS: At least one SN was identified in 39 patients (92.9%). The average number of SNs identified was 2.5 (range, 1~6), and the average number of nodes in each gastric cancer specimen was 23.4 (range, 13~55). 14 patients had lymph nodes containing metastatic disease. 9 patients had metastasis in both sentinel and nonsentinel node. In 5 patients the sentinel nodes was negative for disease, whereas the nonsentinel lymph nodes contained metastatic disease (false negative rate=35.7%). Of these 5 patient, one may have skip metastasis and four had metastasis on same rerional lymph node group. CONCLUSION: Ex vivo SN mapping of the stomach is technically feasible, but it is too early to provide a useful approach to evaluate lymph node metastasis.
Biopsy ; Formaldehyde ; Gastrointestinal Neoplasms ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms*

No abstract available.
Mediastinum*

PURPOSE: The methylenetetrahydrofolate reductase (MTHFR) play a central role in converting folate to methyl donor for DNA methylation. Genetic variation in folate metabolism are believed to contribute to the risk of acute lymphoblastic leukemia, colon, esophageal and stomach cancer, as well as cardiovascular and cerebrovascular disease. Generally, low folate level is known that it is associated with gastrointestinal neoplasm. Three common single nucleotide polymorphisms (SNPs) resulting in amino-acid changes (C677T/Ala222Val, A1298C/Glu428Ala and G1793A/Arg594Glu) has been described in MTHFR. We studied the relation of MTHFR C677T, A1298C and G1793A polymorphisms derived from stomach cancers and a control group in Korean people. METHODS: We performed a case-control study to examine the relationship between MTHFR C677, A1298C and G1793A polymorphism and the risk of stomach cancer. 124 individuals with stomach cancer and 288 healthy persons were analyzed. Blood sampling of each groups were performed, PCR-RFLP analyzed, as a results, MTHFR polymorphism genotypes of 677C/C, 677C/T, 677T/T, 1298AA, 1298AC, 1298CC, 1793GG, 1793GA and 1793AA were obtained. RESULTS: The genotype frequency of MTHFR C677T polymorphisms were 23.4% (CC), 51.6% (CT), 25.0% (TT), 76.6% (CT+TT) in case patients and 39.2% (CC), 36.8% (CT), 24.0% (TT), 60.8% (CT+TT) in control groups. The genotype frequency of MTHFR A1298C polymorphisms were 38.7% (AA), 54.0% (AC), 7.3% (CC), 61.3% (AC+CC) in case patients and 55.6% (AA), 40.3% (AC), 4.2% (CC), 44.4% (AC+CC) in control groups. The genotype frequency of MTHFR G1793A polymorphisms were 82.3% (GG), 16.9% (GA), 0.8% (AA), 17.7% (GA+AA) in case patients and 85.8% (GG), 11.8% (GA), 2.4% (AA), 14.2% (GA+AA) in control groups. 677TT and 677CT genotype was associated with a significantly increased risk for gastric cancer (adjusted OR=2.15, 95% confidence interval 1.16~3.95 in TT, adjusted OR=2.49, 95% CI 1.47~4.20 in CT) than the 677CC genotype, and 1298CC and 1298 AC genotype also was associated with a significantly increased risk for stomach cancer (adjusted OR=2.87, 95% CI 1.10~|7.49 in CC, adjusted OR= 2.07, 95% CI 1.31~3.26 in AC). But 1793AA and 1793GA genotypes were not association with a significantly increased risk for stomach cancer (adjusted OR=0.29, 95% CI 0.03~|2.47 in AA, adjusted OR=1.55, 95% CI 0.84~2.86 in GA) CONCLUSION: MTHFR C677T and A1298C polymorphism may influence stomach cancer, but MTHFR G1793A polymorphism need careful interpretation and confirmation in larger studies.
Case-Control Studies* ; Colon ; DNA Methylation ; Folic Acid ; Gastrointestinal Neoplasms ; Genetic Variation ; Genotype ; Humans ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Polymorphism, Single Nucleotide ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stomach Neoplasms* ; Stomach* ; Tissue Donors

No abstract available.

No abstract available.
Head* ; Neck*

The anti-inflammatory effects of an ethanol extract of Angelica gigas (EAG) were investigated in vitro and in vivo using croton oil-induced inflammation models. Croton oil (20 microgram/mL) up-regulated mRNA expression of cyclooxygenase (COX)-I and COX-II in the macrophage cell line, RAW 264.7, resulting in the release of high concentrations of prostaglandin E2 (PGE2). EAG (1~10 microgram/mL) markedly suppressed croton oil-induced COX-II mRNA expression and PGE2 production. Application of croton oil (5% in acetone) to mouse ears caused severe local erythema, edema and vascular leakage, which were significantly attenuated by oral pre-treatment with EAG (50~500 mg/kg). Croton oil dramatically increased blood levels of interleukin (IL)-6 and PGE2 without affecting tumor-necrosis factor (TNF)-alpha and nitric oxide (NO) levels. EAG pre-treatment remarkably lowered IL-6 and PGE2, but did not alter TNF-alpha or NO concentrations. These results indicate that EAG attenuates inflammatory responses in part by blocking the COX-PGE2 pathway. Therefore, EAG could be a promising candidate for the treatment of inflammatory diseases.
Angelica/*immunology ; Animals ; Cell Line ; Cyclooxygenase 1/genetics/*immunology ; Cyclooxygenase 2/genetics/*immunology ; Dinoprostone/genetics/immunology ; Inflammation/drug therapy/enzymology/*immunology ; Interleukin-6/blood ; Macrophages ; Male ; Mice ; Mice, Inbred ICR ; Nitric Oxide/blood ; Phytotherapy/*methods ; Plant Extracts/*pharmacology/therapeutic use ; Plant Roots/immunology ; RNA, Messenger/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha/blood