Tumor necrosis factor-inducible gene 6 protein (TSG-6) has recently been shown to protect the liver from acute damage. However, the mechanism underlying the effect of TSG-6 on the liver remains unclear. Autophagy is a catabolic process that targets cell components to lysosomes for degradation, and its functions are reported to be dysregulated in liver diseases. Here we investigate whether TSG-6 promotes liver regeneration by inducing autophagic clearance in damaged livers. Mice fed a methionine choline-deficient diet supplemented with 0.1% ethionine (MCDE) for 2 weeks were injected with TSG-6 (the M+TSG-6 group) or saline (the M+V group) and fed with MCDE for 2 additional weeks. Histomorphological evidence of injury and increased levels of liver enzymes were evident in MCDE-treated mice, whereas these symptoms were ameliorated in the M+TSG-6 group. Livers from this group contained less active caspase-3 and more Ki67-positive hepatocytic cells than the M+V group. The autophagy markers ATG3, ATG7, LC3-II, LAMP2A and RAB7 were elevated in the M+TSG-6 group compared with those in the M+V group. Immunostaining for LC3 and RAB7 and electron microscopy analysis showed the accumulation of autophagy structures in the M+TSG-6 group. TSG-6 also blocked both tunicamycin- and palmitate-induced apoptosis of hepatocytes and increased their viability by inducing autophagy formation in these cells. An autophagy inhibitor suppressed TSG-6-mediated autophagy in the injured hepatocytes and livers of MCDE-treated mice. These results therefore demonstrate that TSG-6 protects hepatocytes from damage by enhancing autophagy influx and contributes to liver regeneration, suggesting that TSG-6 has therapeutic potential for the treatment of liver diseases.
Animals ; Apoptosis ; Autophagy* ; Caspase 3 ; Cellular Structures ; Diet ; Ethionine ; Hepatocytes ; Liver Diseases ; Liver Regeneration ; Liver* ; Lysosomes ; Methionine ; Mice* ; Microscopy, Electron ; Necrosis*

BACKGROUND/AIMS: Chronic liver disease leads to liver fibrosis, and although the liver does have a certain regenerative capacity, this disease is associated with dysfunction of the liver vessels. C-reactive protein (CRP) is produced in the liver and circulated from there for metabolism. CRP was recently shown to inhibit angiogenesis by inducing endothelial cell dysfunction. The objective of this study was to determine the effect of CRP levels on angiogenesis in a rat model of liver dysfunction induced by bile duct ligation (BDL). METHODS: The diameter of the hepatic vein was analyzed in rat liver tissues using hematoxylin and eosin (H&E) staining. The expression levels of angiogenic factors, albumin, and CRP were analyzed by real-time PCR and Western blotting. A tube formation assay was performed to confirm the effect of CRP on angiogenesis in human umbilical vein endothelial cells (HUVECs) treated with lithocholic acid (LCA) and siRNA-CRP. RESULTS: The diameter of the hepatic portal vein increased significantly with the progression of cirrhosis. The expression levels of angiogenic factors were increased in the cirrhotic liver. In contrast, the expression levels of albumin and CRP were significantly lower in the liver tissue obtained from the BDL rat model than in the normal liver. The CRP level was correlated with the expression of albumin in hepatocytes treated with LCA and siRNA-CRP. Tube formation was significantly decreased in HUVECs when they were treated with LCA or a combination of LCA and siRNA-CRP. CONCLUSION: CRP seems to be involved in the abnormal formation of vessels in hepatic disease, and so it could be a useful diagnostic marker for hepatic disease.
Angiogenic Proteins/genetics/metabolism ; Animals ; Bile Ducts/surgery ; C-Reactive Protein/*analysis/genetics/metabolism ; Cells, Cultured ; Disease Models, Animal ; Hepatic Veins/abnormalities ; Hepatocytes/cytology/metabolism ; Human Umbilical Vein Endothelial Cells ; Humans ; Lithocholic Acid/pharmacology ; Liver/metabolism/pathology ; Liver Cirrhosis/etiology ; Liver Diseases/metabolism/*pathology ; Male ; Microscopy, Fluorescence ; Mitochondria/drug effects/metabolism ; RNA Interference ; RNA, Small Interfering/metabolism ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Serum Albumin/genetics/metabolism

Rituximab is a monoclonal antibody that targets B-lymphocytes, and it is widely used to treat non-Hodgkin's lymphoma. However, its use has been implicated in HBV reactivation that's related with the immunosuppressive effects of rituximab. Although the majority of reactivations occur in hepatitis B carriers, a few cases of reactivation have been reported in HBsAg negative patients. However, reactivation in an HBsAg negative/ HBsAb positive patient after rituximab treatment has never been reported in Korea. We present here an HBsAg-negative/HBsAb-positive 66-year-old female who displayed reactivation following rituximab plus CHOP chemotherapy for diffuse large B-cell lymphoma. While she was negative for HBsAg at diagnosis, her viral status was changed at the time of relapse as follows: HBsAg positive, HBsAb negative, HBeAg positive, HBeAb negative and an HBV DNA level of 1165 pg/ml. Our observation suggests that we should monitor for HBV reactivation during rituximab treatment when prior HBV infection or occult infection is suspected, and even in the HBsAg negative/HBsAb positive cases.
Aged ; Antibodies, Monoclonal, Murine-Derived ; B-Lymphocytes ; DNA ; Female ; Hepatitis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Organothiophosphorus Compounds ; Recurrence ; Rituximab

The outcomes of the treatment of thrombotic thrombocytopenic purpura (TTP) have been shown to be improved by the administration of plasma exchange. However, treatment options are currently limited for cases refractory to plasma exchange. The autoantibodies that block the activity of ADAMTS13 have been demonstrated to play a role in the pathogenesis of TTP; therefore, high-dose immunoglobulin, which can neutralize these autoantibodies, may be useful for refractory TTP. However, successful treatment with high-dose immunoglobulin for TTP refractory to plasma exchange and corticosteroids has yet to be reported in Korea. Herein, we describe a refractory case which was treated successfully with high-dose immunoglobulin. A 29-year-old male diagnosed with TTP failed to improve after plasma exchange coupled with additional high-dose corticosteroid therapy. As a salvage treatment, we initiated a 7-day regimen of high-dose immunoglobulin (400 mg/kg) infusions, which resulted in a complete remission, lasting up to the last follow-up at 18 months. High-dose immunoglobulin may prove to be a useful treatment for patients refractory to plasma exchange; it may also facilitate recovery and reduce the need for plasma exchange.
Adrenal Cortex Hormones/*therapeutic use ; Adult ; Humans ; Immunoglobulins/administration & dosage/*therapeutic use ; Male ; *Plasma Exchange ; Purpura, Thrombotic Thrombocytopenic/*drug therapy ; Recurrence/prevention & control ; Salvage Therapy ; Treatment Failure

PURPOSE: Tumor cells are known to express hypoxia-related proteins such as glucose transporter-1 (Glut-1). These hypoxia-induced changes may allow tumor cells to survive under sustained hypoxic microenvironments, and the surviving tumor cell under hypoxia may develop a more aggressive phenotype and so result in a poor prognosis. MATERIALS AND METHODS: The Glut-1 expression was analyzed by immunohistochemistry, and its association with the prognosis was assessed in 60 patients with squamous cell carcinoma of the tongue. RESULTS: The Glut-1 expression was diffuse with a membranous pattern, and the median percentage of Glut-1 positive tumor cells was 60% (range: 0.0~90.0%). A high Glut-1 expression (the percentage of positive tumor cells > or = the median value, 60%) was associated with the location of primary lesion, lymph node metastasis status and disease stage (p<0.05). The expression of Glut-1 was correlated with the Ki-67 expression (r=0.406, p=0.001). Microvessel density, as represented by CD31 staining, was also correlated with the Glut-1 expression although its significance is weak (r=0.267, p=0.039). On the univariate analysis, the group with a high Glut-1 expression showed poorer overall survival than the group with a low Glut-1 expression (p<0.05). However, the Glut-1 expression failed to show any independent prognostic significance on the multivariate analysis. CONCLUSION: The expression of Glut-1 may be useful for predicting the prognosis and determining the treatment strategy for the management of squamous cell carcinoma of the tongue.
Anoxia ; Carcinoma, Squamous Cell* ; Glucose* ; Humans ; Immunohistochemistry ; Lymph Nodes ; Microvessels ; Multivariate Analysis ; Neoplasm Metastasis ; Phenotype ; Prognosis ; Tongue*

Intussusception in an adult is an uncommon condition. In contrast to the condition occuring in infants and children in adults, it is usually secondary to an intraluminal tumor. Hemangioma is a very rare cause of intussusception. The most frequent symptoms of intussuscepting hemangioma of the gastrointestinal tract are cramping abdominal pain, vomiting and melena. The treatment is usually resection. We experienced a case of hemangioma in the ileum with intussusception. After laparotomy and resection of the ileal segment, end to end anastomosis was performed.
Abdominal Pain ; Adult ; Child ; Gastrointestinal Tract ; Hemangioma* ; Humans ; Ileum* ; Infant ; Intussusception ; Laparotomy ; Melena ; Muscle Cramp ; Vomiting

Obturator hernia is a rare pelvic hernia, occuring most frequently in elderly, debilitated women. Because of nonspecific symptoms, the diagnosis of obturator hernia is often delayed until laparotomy for bowel obstruction. This leads to high bowel resection and mortality rates, which represents a diagnostic and therapeutic challenge for surgeons today. We experienced an unusual case of right obturator hernia with strangulation in an 81-year-old female patient who presented with intermittent generalized, particularly right lower quadrant, abdominal pain and distension. The hernia was diagnosed by computed tomography (CT) scan and repaired using the lower midline transperitoneal approach. CT scan in the evaluation of patients with nonspecific intermittent gastrointestinal symptoms leads to a diagnosis of occult hernia. We report these findings with a brief review of the literature focusing on finding indicators leading to early diagnosis and treatment.
Abdominal Pain ; Aged ; Aged, 80 and over ; Diagnosis* ; Early Diagnosis ; Female ; Hernia ; Hernia, Obturator* ; Humans ; Ileus ; Laparotomy ; Mortality ; Tomography, X-Ray Computed

BACKGROUND: The Fitzpatrick skin type has been a simple and useful method to categorize cutaneous sensitivities to ultraviolet radiation. OBJECTIVE: In this study, we intended to know the distribution of Fitzpatrick skin type in Korean by interview method using questionnaire. METHODS: A total of 1296 Koreans from various districts were included in this study. Each subject was interviewed about their skin reactions to ultraviolet radiation and determined their skin type by interview method. To evaluate the statistical significance, we used generalized logit model. RESULTS: 1. The order of frequency of skin type was type III(48.8%), IV(22.2%), V(17.8%) by the interview method, with the sun sensitive categories(type I and type II) reported for 11.2%. 2. The skin type III was the predominant skin type in both men and women. However, skin type IV was found more frequently in men and it was statistically significant. 3. There is a tendency that frequency of skin type IV and V were increasing with advancement of age. 4. The Fitzpatrick skin type has some relationship with each individual`s occupation, the degree of sun exposure and their own skin color in Korean. CONCLUSION: This study included relative large numbers of subjects from various districts in Korea. It can be used as basic data for various studies related to cutaneous reactions to ultraviolet radiation.
Female ; Humans ; Korea ; Logistic Models ; Male ; Occupations ; Skin* ; Solar System ; Surveys and Questionnaires

BACKGROUND: The Fitzpatrick skin type has been a simple and useful method to categorize cutaneous sensitivities to ultraviolet radiation. OBJECTIVE: In this study, we intended to know the distribution of Fitzpatrick skin type in Korean by interview method using questionnaire. METHODS: A total of 1296 Koreans from various districts were included in this study. Each subject was interviewed about their skin reactions to ultraviolet radiation and determined their skin type by interview method. To evaluate the statistical significance, we used generalized logit model. RESULTS: 1. The order of frequency of skin type was type III(48.8%), IV(22.2%), V(17.8%) by the interview method, with the sun sensitive categories(type I and type II) reported for 11.2%. 2. The skin type III was the predominant skin type in both men and women. However, skin type IV was found more frequently in men and it was statistically significant. 3. There is a tendency that frequency of skin type IV and V were increasing with advancement of age. 4. The Fitzpatrick skin type has some relationship with each individual`s occupation, the degree of sun exposure and their own skin color in Korean. CONCLUSION: This study included relative large numbers of subjects from various districts in Korea. It can be used as basic data for various studies related to cutaneous reactions to ultraviolet radiation.
Female ; Humans ; Korea ; Logistic Models ; Male ; Occupations ; Skin* ; Solar System ; Surveys and Questionnaires

BACKGROUND: Although deleterious effects of sunlight have been increased recently, the surveillance of the attitudes toward sun-exposure and the behavioral aspect of using sunscreens in Koreans has hot been cammied out. OBJECTIVE: Our purpose was to evaluate the attitude toward the harmfulness of sun-exposure and behaviors of using sunscreens in Korea. METHOD: Five hundred and fifty-two subjects were surveyed to assess the attitude toward sun-exposure, as well as the subjects' knowledge about, and the use of sunscreens. Underlying data including demographic data, skin colors, skin types, occupation, and sun-exposure, were obtained. RESULTS: Fifty-four percent of subjects believed that sun-exposure is bad for their skins, but, on the contrary, 12.5% believed it to be beneficial. Fifty-two percent of subjects used sunscreens. Almost all subjects(93.8%) knew why to use sunscreens but 62.7% of subjects did not know the meaning of sun protective factors(SPF). Women, indoor workers, subjects older than 40 yearsold, with less sun-exposed, fair colored skin, or with skin type I, II, III tended to know the deleterious effects of sunlight and the meaning of SPF and used more sunscreen. CONCLUSION: High risk population - men, outdoor workers, subjects less than 40 yearsold, with more sun-exposed, dark colored skin, or skin type VI, V could be targeted with campaigns that promote attitudinal and behavioral changes.
Female ; Humans ; Korea* ; Male ; Occupations ; Skin ; Solar System ; Sunlight ; Sunscreening Agents*