Glucocorticoids are usually given according to a standard dosing protocol regardless of individual difference. We evaluated the pharmacokinetic characteristics of methylprednisolone and the degree of interpatient variation in stable Korean renal transplant recipients during the period of 15-21 days after transplantation. This study included 23 renal transplant recipients, 13 males and 10 females, who received kidneys from living donors with stable graft function and without episode of acute rejection. On the study day at 8 A.M., 16.3mg of ethylprednisolone sodium succinate (i.v.) was administered to each patient instead of usual dose (20mg) of prednisolone (p.o.) after sampling of 7cc of baseline blood and additional blood samples were drawn after starting infusion. Plasma was separated and analyzed for methylprednisolone level using high performance liquid chromatography (HPLC) assay, and parameters for pharmacokinetics were calculated. There was significant interpatient variation in the pharmacokinetics of methylprednisolone in our patients group. There was no significant difference in the pharmacokinetic parameters between patients with and without side effects of steroid. Korean renal transplant recipients had higher volume of distribution than black renal transplant recipients; lower clearance than white renal transplant recipients; longer t1/2 than both black and white renal transplant recipients. Even if the number of patients included in this study was too small to reach conclusion, the differences in the pharmacokinetics of glucocorticoids do not seem to be a significant risk factor for side effects of steroid after transplantation. It may be necessary to individualize the dose of a glucocorticoid to achieve an optimal effect and also we need to establish a new steroid regimen protocol for Korean renal transplant recipients.
Chromatography, Liquid ; Female ; Glucocorticoids ; Humans ; Individuality ; Kidney ; Kidney Transplantation ; Living Donors ; Male ; Methylprednisolone* ; Pharmacokinetics ; Plasma ; Prednisolone ; Risk Factors ; Sodium ; Succinic Acid ; Transplantation* ; Transplants

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*

No abstract available.
Breast Neoplasms* ; Breast* ; Ultrasonography*

BACKGROUND: High mobility group box 1 (HMGB1) is a novel, late mediator of inflammation. This study compared the pro-inflammatory effects of LPS and HMGB1. The transcriptional factors that play an important role in mediating the HMGB1-induced stimulation of IL-8 were also evaluated. METHODS: RAW264.7 cells were stimulated with either LPS (100 ng/ml) or HMGB1 (500 ng/ml). The TNF-alpha, MIP-2 and IL-1beta levels in the supernatant were evaluated by ELISA at 0, 2, 4, 8, 12 and 24h after stimulation. An acute lung injury was induced by an injection of LPS (5 mg/kg) or HMGB1 (2.5 mg/kg) into the peritoneum of the Balb/c mice. The lung cytokines and MPO activity were measured at 4h (for LPS) or 24h (for HMGB1) after the injection. The transcriptional factor binding sites for NF-IL6, NF-kappaB and AP-1 in the IL-8 promoter region were artificially mutated. Each mutant was ligated with pIL-6luc and transfected into the RAW264.7 cells. One hour after stimulation with HMGB1 (500 ng/ml), the cell lysate was analyzed for the luciferase activity. RESULTS: The expression of MIP-2, which peaked at 8h with LPS stimulation, increased sequentially until 24h after HMGB1 stimulation. An intraperitoneal injection of HMGB1, which induced a minimal increased in IL-1beta expression, provoked the accumulation of neutrophils the lung. A mutation of AP-1 as well as NF-kappaB in the IL-8 promoter region resulted in a lower luciferase activity after HMGB1 stimulation. CONCLUSION: The proinflammatory effects of HMGB1, particularly on IL-8, are mediated by both NF-kappaB and AP-1.
Acute Lung Injury ; Animals ; Binding Sites ; CCAAT-Enhancer-Binding Protein-beta ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; HMGB1 Protein* ; Inflammation ; Injections, Intraperitoneal ; Interleukin-8* ; Luciferases ; Lung ; Mice ; Negotiating ; Neutrophils ; NF-kappa B ; Peritoneum ; Promoter Regions, Genetic ; Transcription Factor AP-1 ; Tumor Necrosis Factor-alpha

Granulocyte macrophage-colony stimulating factor (GM-CSF) has immuno-stimulatory effects. We hypothesized that GM-CSF plays an important role both in lipopolysaccharide (LPS)- and hemorrhage-induced acute lung injury (ALI). We also postulated that GM-CSF augments LPS-induced inflammation by priming neutrophils. ALI was induced in GM-CSF-/- or control C57BL mice either by LPS injection or by hemorrhage. Lung inflammation (by lung expression for tumor necrosis factor-alpha (TNF-alpha), macrophage inflammatory protein-2 (MIP-2), interleukin-1beta (IL-1beta), interleukin- 6 (IL-6), and keratinocyte-derived chemokine) and lung injury (by myeloperoxidase and evans blue dye assay) were evaluated after ALI. Incremental doses of LPS (0, 1, 10, and 100 ng/mL) and GM-CSF (0, 1, 10, and 100 ng/mL) were added to bone marrow neutrophils. The expression of TNF-alpha, MIP-2, and IL-1beta was evaluated with enzyme linked immunosorbent assay. The mRNA expression of three cytokines, and the nuclear translocation of nuclear factor kappa B (NF kappa-B) were evaluated by reverse transcriptase-polymerase chain reaction and electropnoretic mobility shift assay, respectively. GM-CSF -/- mice showed decreased neutrophil infiltration, less leakage, and lower expression of cytokines in the lung after LPS or hemorrhage. GM-CSF augmented LPS-induced protein and mRNA expression of TNF-alpha, MIP-2 and IL-1beta, which was mediated by increased intra-nuclear translocation of NF-kappa B. GM-CSF plays an important role in high-dose LPS and hemorrhage-induced ALI, which appears to be mediated by its priming effect on neutrophils.
Animals ; Bone Marrow Cells/cytology ; Chemokine CXCL2/metabolism ; Granulocyte-Macrophage Colony-Stimulating Factor/metabolism/*physiology ; Interleukin-1beta/metabolism ; Lipopolysaccharides/metabolism ; Lung/metabolism/pathology ; *Lung Injury ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Transgenic ; Neutrophils/*cytology/metabolism ; Peroxidase/metabolism ; Tumor Necrosis Factor-alpha/metabolism

Approximately one-third of all patients with renal cell carcinoma have metastasis at the time of diagnosis. Metastatic lesions of renal cell carcinoma are most commonly seen in the lung, and they are frequently seen in the bone and liver. However, spleen and rectal metastases are extremely rare. A 63-year-old man had undergone left radical nephrectomy for renal cell carcinoma. About 22 months later, computed tomography revealed multiple enhanced masses in the spleen. Spleen metastasis was suspected and splenectomy was then performed. One year later, the patient visited with complaints of voiding difficulty. A huge pelvic mass was detected by performing prostate ultrasonography and MRI. The mass was 13cm in diameter and it was between the rectum and the prostate. Removal of the pelvic mass and lower anterior resection with end colostomy was done. Histologically, the resected specimens were diagnosed as metastases from the renal cell cancer. Herein, we report on a case of metachronous splenic and rectal metastasis from renal cell carcinoma.
Carcinoma, Renal Cell* ; Colostomy ; Diagnosis ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy ; Prostate ; Rectum ; Spleen ; Splenectomy ; Ultrasonography

BACKGROUND: Lipoprotein(a)[Lp(a)], an independent risk factor for athrosclerosis, consist of low density lipoprotein like particle and specific glycoprotein, apolipoprotein(a). The levels of Lp(a) are mainly determined by the genetic pleomorphism of apolipoprotein(a) and has been though not to be influenced by age, sex and other biochemical parameters. Recent reports have shown that the concentrations of Lp(a) are correlated with age in women. The purpose of this study was to invastigate the association of Lp(a) concentration with sex and age. METHODS: The concentrations of Lp(a) were measured in 3,707 women and 389 men, free of diseases and medications known to affect the lipid levels. Plasma Lp(a) concentration were measured by commercial radioimmunoassay kit and other lipid profiles by conventional method. RESULTS: In female, median Lp(a) concentration increased with age till the early sixth decade (P=.0000) and then decreased. If peri- and postmenopausal women were excluded in the fifth decades, the relation between age and Lp(a) disappeared. In male, Lp(a) concentration were not associated with age. Median Lp(a) concentrations were higher in females than in males in the fifth(p=.0039) and the sixth decades(p=.0007), The difference became negligible after the exclusion of peri- and postmenopausal woman in the fifth decade. CONCLUSION: The concentrations of Lp(a) were corrected with age only in female. Females had higher levels than males in the fifth and the sixth decades. The relations are thought to be nither due to aging process nor sex but due to postmenopausal increase of Lp(a).
Aging ; Apoprotein(a) ; Female ; Glycoproteins ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Male ; Menopause ; Plasma ; Radioimmunoassay ; Risk Factors

BACKGROUND: Lipoprotein(a)[Lp(a)], an independent risk factor for athrosclerosis, consist of low density lipoprotein like particle and specific glycoprotein, apolipoprotein(a). The levels of Lp(a) are mainly determined by the genetic pleomorphism of apolipoprotein(a) and has been though not to be influenced by age, sex and other biochemical parameters. Recent reports have shown that the concentrations of Lp(a) are correlated with age in women. The purpose of this study was to invastigate the association of Lp(a) concentration with sex and age. METHODS: The concentrations of Lp(a) were measured in 3,707 women and 389 men, free of diseases and medications known to affect the lipid levels. Plasma Lp(a) concentration were measured by commercial radioimmunoassay kit and other lipid profiles by conventional method. RESULTS: In female, median Lp(a) concentration increased with age till the early sixth decade (P=.0000) and then decreased. If peri- and postmenopausal women were excluded in the fifth decades, the relation between age and Lp(a) disappeared. In male, Lp(a) concentration were not associated with age. Median Lp(a) concentrations were higher in females than in males in the fifth(p=.0039) and the sixth decades(p=.0007), The difference became negligible after the exclusion of peri- and postmenopausal woman in the fifth decade. CONCLUSION: The concentrations of Lp(a) were corrected with age only in female. Females had higher levels than males in the fifth and the sixth decades. The relations are thought to be nither due to aging process nor sex but due to postmenopausal increase of Lp(a).
Aging ; Apoprotein(a) ; Female ; Glycoproteins ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Male ; Menopause ; Plasma ; Radioimmunoassay ; Risk Factors

OBJECTIVES: Cardiovascular disease is the leading cause of death and a major source of workers' compensation claims in Korea. Since 2000 the Korea Occupational Safety and Health Agency (KOSHA), working through local occupational health institutions, has supported cardiovascular disease prevention programs at a number of companies in Korea. The purpose of this study was to assess the short-term effects of this effort. METHODS: A total of 11,077 workers at risk were enrolled in the workplace cardiovascular disease prevention program and 5,902 workers (53.3%) completed the 1-year course during 2007. The program consisted of a medical checkup and health counseling for the workers by occupational health nurses. The guidelines for this prevention program were adopted from KOSHA Code H-11-2004. To determine the program's effectiveness, the workers' risks for cardiovascular disease were assessed before and one year after completion of the program. RESULTS: The intervention led to significant reductions in the mean systolic and diastolic blood pressures of 4.9 mmHg and 3.1 mmHg, respectively. Mean total cholesterol and BMI were also reduced significantly by 8.4 g/dl and 0.1 kg/m2. The rate of smoking was decreased by 6.0% and the percentage of workers engaging in regular exercise was increased by 23.1%. Of the 3,530 workers with the low risk and above, the overall cardiovascular risk was improved in 1,734 (49.1%) of them. CONCLUSIONS: The cardiovascular disease prevention program supported by the Korea Occupational Safety and Health Agency reduces cardiovascular diseases risks among workers and may improve the health status of workers in Korea.
Cardiovascular Diseases ; Cause of Death ; Cholesterol ; Counseling ; Government Programs ; Health Promotion ; Korea ; Occupational Health ; Smoke ; Smoking ; Workers' Compensation