PURPOSE: recent studies have reported that the expression of Drg-1 is up-regulated by androgen. It has been suggested that Drg-1 gene be used as a molecular marker for prostate cancer therapies like PSA. To de termine the role of Drg-1 gene as a molecular marker during intermittent androgen deprivation(IAD) therapy, we investigated the expression of Drg-1 and compared it with PSA expression in human prostate cancer cell lines treated with dihydrotestosterone (DHT) continuously or intermittently. MATERIALS AND METHODS: Two prostate cancer cells having different status of androgen receptor [LNCaP (androgen dependent) and PC-3 (androgen independent)] were used in this study. To know the change in PSA and Drg-1 expression after DHT treatment the cells were cultured in steroid-free RPMI media for 24 hours. 10(-7) and 10(-8)M of DHT and 10(-7)M bicalutimide was added into the cells and then cultured for 72 hours. And we established in vitro IAD model using LNCaP cells. Northern analyses were performed to determine the expression level of both PSA and Drg-1genes. Also, western analyses were performed to determine the protein level of proliferating cellular nuclear antigen and androgen receptor. RESULTS: Transcripts of Drg-1 were detected in both LNCaP and PC-3 cells but PSA was not expressed in PC-3 cells. The expression of Drg-1gene in LNCaP cells was up-regulated by 10(-8)M of DHT like PSA gene and down-regulated by 10(-7)M bicalutamide. In the treatment of intermittent androgen deprivation, the expression pattern of Drg-1was similar to that of PSA. However, up-regulation of PSA was detected earlier than of Drg-1. CONCLUSIONS: Based on observation, Drg-1 was up-regulated by androgen and down-regulated by anti-androgen. This suggests that Drg-1gene is useful for determining the androgen independency of prostate cancer during IAD.
Cell Line ; Dihydrotestosterone ; Humans ; Prostate* ; Prostatic Neoplasms* ; Receptors, Androgen ; Up-Regulation

Glycopyrrolate and propantheline, being synthetic quaternary ammonium compounds that cannot cross the blood-brain barrier, will not have the vagal center stimulation. The author administered each small dose of glycopyrrolate and propantenline intravenously to normal human volunteers, and compared its effect on the heart rate. The result were as follows. 1) Glycopyrrolate(0.1mg) produced a slight decrease on the heart rate. 2) Propantheline (0.5mg) produced no detectable change on the heart rate. 3) Glycopyrrolate(0.1mg) 10min. after pretreatment with propantheline(0.5mg) produced a significant increase on the heart rate. 4) Propantheline(0.5mg) 10 minutes after pretreatment with glycopyrrolate(0.1mg) produced more significant increase on the heart rate than glycopyrrolate after propantheline. 5) From the above results, it is suggested that the depressive effect of sympathetic ganglion by propantheline may be less than by glycopyrrolate.
Blood-Brain Barrier ; Ganglia, Sympathetic ; Glycopyrrolate* ; Healthy Volunteers ; Heart Rate* ; Heart* ; Propantheline* ; Quaternary Ammonium Compounds

There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul

Ulcer in buttock is mainly a pressure sore, which is frequently occurred at the sacral region in Korea and its surgical treatment is chiefly the operation using gluteus maximus myocutaneons flaps. For the treatment of ulcerated lesion in gluteal area, various methods using gluteus maximus muscle have been developed. We reviewed and analyzed the 100 cases using gluteus maximus myocutaneous flaps in our department since 1980. The results were summarized as follows ; 1) The ratio between male and female was 3:1. 2) The prevalent age groups were between third and fifth decades. 3) The main cause was the trauma. 4) The wound culture showed the pattern of mixed infections in most cases, consisting of Staphylociccus, Pseudomonas, Enterococcus, Streptococcus, and others. 5) The postoperative complications were noted in about thirty percent of the cases. The complications were flap tip necrosis, wound infection, wound disruption, and others. 6) For the treatment of small ulcers, a pure skin flap or myoplasty may be used, but for the treatment of large one, a kind of myocutaneous flap should be selected. 7) Gluteus maximus myocutaneous flaps can be used as variable methods, but of which the island flap is ideal in deep and large ulcerated lesion.
Buttocks ; Coinfection ; Enterococcus ; Female ; Humans ; Korea ; Male ; Myocutaneous Flap* ; Necrosis ; Postoperative Complications ; Pressure Ulcer ; Pseudomonas ; Sacrococcygeal Region ; Skin ; Streptococcus ; Ulcer ; Wound Infection ; Wounds and Injuries

Clinical manifestations caused by vascular complications including stenosis, occlusion, aneurysm and arteriovenous malformation were rarely developed in patients with neurofibromatosis. We reviewed 23 cases of neurofibromatosis type I to identify the histopathologic features of vessels in neurofibromatosis associated with clinical features. The results were as follows: 1. The age of patients ranged from 4 to 61 years(mean: 23 years) at diagnosis and sex ratio of male to female was 1.3 : 1. The family history was present in 52%(12/23) of the patients. Angiographically, 3 cases of atherosclerosis, 1 case of arteriovenous malformation, and 1 case of aneurysm were seen. 2. peculiar vascular alternations were found in 7 of 23 cases of neurofibromatosis, which were classified as 4 types: 6 cases of pure intimal; 3 cases of advanced intimal; 1 case of intimal-aneurysmal; 3 cases of nodular type. The most frequent type of vascular lesions was observed in the patients with neurofibromatosis was Pure intimal, and the most uncommon one was intimal-aneurysmal. 3. Immunohistochemically, the positivity to S-100 protein was noted in the tumor cells arranged in the periphery of vessels, but no reaction was seen in the spindle or epithelioid cells within the vascular wall. In conclusion, the vascular lesions associated with neurofibromatosis may result from abnormal proliferation of cells in the vascular wall, possibly smooth muscle cells, not Schwann cells in origin. The various types of lesions described previously appear to be of stage of development.
Aneurysm ; Arteriovenous Malformations ; Atherosclerosis ; Constriction, Pathologic ; Diagnosis ; Epithelioid Cells ; Female ; Humans ; Male ; Myocytes, Smooth Muscle ; Neurofibromatoses* ; Neurofibromatosis 1 ; S100 Proteins ; Schwann Cells ; Sex Ratio

PURPOSE: Chest irradiation leads to a significant cardiac injury in a number of patients. To prevent, or to reduce the risk of radiation-induced cardiac injury, pentosifylline(PTX), a haemorrheologic agent that improves the blood flow through small blood capillaries has been employed. MATERIALS AND METHODS: One hundred and eighty ICR mice were divided into three study groups : control, radiation alone, and radiation-pentoxifylline. Each group was subdivided into 12 subgroups: 1,3,6 and 10 days and 2, 3, 4, 6, 8, 12, 16 and 20 weeks y observation period after irradiation. The total 15 Gy of radiation was delivered in a single fraction ghrough anterior mediastinal port. Pentoxifylline was injected subcutaneously daily 50mg/k to the back of the mice from the first day of irradiation throughout the observation period. The mice of each group after a certain observation period were sacrificed and sectioned for histopathologic examination of the heart. RESULTS: he findings of acute radiation-induced carditis i.e., heterohpilic infiltration and vacuolization and ballooning of endotherlial cells were onserved upto weeks and reduced sharply afterwards. The late radiation effects including pericarditis with mononuclear cell infiltration, pericardial fibrosis, endothelial cell changes, myocardial degenerationa dn fibrosis present from 4 weeks onwards after irradiation but with various degree of severity. The overall process of pathologic changes of radiation-pentoxify-acute stage was relatively short and the severity of late cardiac toxicity was much lesser compared with those of radiation alone group. CONCLUSION: Pentoxifyllline can effectively reduce the late radiation-induced cardiac injury and resolve the acute effects relatively rapidly.
Animals ; Capillaries ; Endothelial Cells ; Fibrosis ; Heart ; Humans ; Mice ; Mice, Inbred ICR* ; Myocarditis ; Pentoxifylline* ; Pericarditis ; Radiation Effects ; Thorax

Ludwig’s angina is a rapidly progressive and gangrenous cellulitis in the submandibular, sublingual spaces, and neck. It is characterized by an elevated tongue and laryngeal edema, resulting in airway compromise and, rarely, in sudden death. The most common cause is an odontogenic infection of a molar tooth. Infection can spread to the superior mediastinum and buccal area through anatomical structures. Herein, we report the sudden death of a 45-year-old male who was not diagnosed with Ludwig’s angina. He died in the emergency room 20 minutes after loss of consciousness. Intubation was impossible owing to severe laryngeal edema. The C-reactive protein level was 33.81 mg/dL. On autopsy, a diffuse light green abscess of the submandibular space was detected, along with severe edema of the epiglottis, aryepiglottic fold, and vocal cords. Subsequently, we confirmed that the airway obstruction was caused by Ludwig’s angina based on a literature review. In conclusion, this report emphasizes the need to identify the infection source and perform a detailed dissection according to the anatomical structure in the autopsy procedure for Ludwig’s angina.

Supplementation of antihypertensive action of sodium nitroprusside (SNP) is almost standard practice and should obviate the need for potentially toxic doses to control blood pressure. Clonidine, an antihypertensive agent known to reduce sympathetic outfiow via alpha2-adrenergic receptor stimulation, has been shown to decrease MAC of halogenated agent, and to reduce the amount of SNP required to reduce the desired hypotension. To determine the effects of clonidine on the hemodynamics and intrapulmonary shunting during SNP infusion, clonidine and/or SNP were administered to 22 patients anesthetized with halothane-N2, O-O2 (FIO2:0.5) In one group of 11 patients, clonidine 1.5ug/kg was injected intravenously. In another group of 11 patients, clonidine 1.5 ug/kg was injected intravenously 30 minutes after starting the SNP infusion (3 ug/kg/min). The results were as follows. 1) Clonidine alone produced a small decrease in MAP (10%) and CI (8%) but other hemodynamic values remained unaltered. 2) Arterial oxygen tension and intrapulmonary shunting was not changed by clonidine. 3) Heart rate (15%) was increased , but MAP (29%), MPAP (24%), PCWP (25%), CVP (32% ), SVR (29%)and PVR(24%) were decreased significantly, and CI, SVI remained unchanged during SNP hypotension. 4) SNP caused a significant increase in intrapulmonary shunt fraction from 8.62% to 10.58% and a decrease in PaO2. 5) In group of clonidine under SNP infusion, conidine did not significantly affect the hemodynamic response to SNP except for 15% decrease in BP. 6) Clonidine caused no significant change on gas exchange effect of SNP. These results indicate that clonidine did not significantly affect the hemodynamics and intrapul-monary shunting during SNP hypotension. Therefore, clonidine could be used as a valuable adjuvant for reducing the amount of SNP and decreasing MAC of halothane.
Anesthesia* ; Blood Pressure ; Clonidine* ; Halothane ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium*

BACKGROUND: Recently, a variety of cigarettes which contain a low content of nicotine are on the market and the nicotine tends to be reduced continuously. However, studies have not yet fully demonstrated that low-nicotine cigarettes are subservient to quitting smoking. This study was designed to investigate the effects of the nicotine content on smoking attitudes and on the factors associated with successful smoking cessation. METHODS: One hundred twenty-five adult smokers, who had undergone a health examination in a general hospital, had their carbon monoxide measured after responding to the questionnaire. The items of questionnaire consisted of the duration of smoking, the age of starting to smoke, the number of attempts to stop smoking, recognition of nicotine dependence, and nicotine dependence score. RESULTS: The subjects consisted of two groups. One group was low nicotine group and the nicotine content was lower than 0.35 mg per cigarette. The other group was high nicotine group and the nicotine content was over 0.35 mg per cigarette. he age was younger and duration of smoking was shorter in low nicotine group. Monthly income, last schooling and number of attempts to stop smoking were higher in low nicotine group. There was no statistical significant differences between the two groups in the frequency of alcohol drinking, the age of starting to smoke, marital status, nicotine dependence, carbon monoxide concentration and recognition of nicotine dependence. CONCLUSION: As there was no differences in smoking habits which has infl uence on achieving quit smoking of low nicotine group, we made our conclusion that low nicotine cigarette might be unhelpful in quit smoking.
Adult ; Alcohol Drinking ; Carbon Monoxide ; Hospitals, General ; Humans ; Marital Status ; Nicotine ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products ; Tobacco Use Disorder

PURPOSE: Endoscopic subureteral injection of dextranomer/hyaluronic acid copolymer (Deflux(R)) has become an established alternative to long-term antibiotic prophylaxis and open ureteral reimplantation for the management of vesicoureteral reflux (VUR) in children. We retrospectively evaluated the risk factors for treatment failure after endoscopic correction of VUR. MATERIALS AND METHODS: Between 2005 and 2007, 23 boys and 26 girls (total of 69 ureters) with VUR underwent endoscopic subureteral injection of Deflux(R) primarily. VUR was unilateral in 29 patients and bilateral in 20 patients. Of the 69 ureters, VUR was grade II to V in 13, 28, 20, and 8, respectively. Follow-up urinalysis and ultrasonography were performed 1 and 3 months after the procedure, and a voiding cystourethrogram was performed at 6 or 9 months postoperatively. RESULTS: Treatment failure was defined as persistent VUR of grade II or over grade II. Endoscopic correction failed in 22 of 69 refluxing ureters. Age, sex, laterality, number of preoperative urinary tract infections, time from diagnosis to operation, presence of renal scarring, and injection volume did not influence outcome. However, preoperative presence of voiding symptoms, high-grade reflux and hydronephrosis, and having a horseshoe or golf-hole shaped ureteral orifice had a negative influence on the treatment result by univariate analysis. Severe dilatation of the lower ureter was the only statistically significant factor by multivariate analysis. CONCLUSIONS: Severity of lower ureteral dilatation is the most significant factor influencing the failure of endoscopic subureteral injection of Deflux(R). Other factors significantly involved in failure are the presence of voiding symptoms, high-grade reflux and hydronephrosis, and a horseshoe or golf-hole shaped ureteral orifice. Success rates may improve if we carefully consider these influencing factors before choosing an operative method.
Antibiotic Prophylaxis ; Child ; Cicatrix ; Dilatation ; Follow-Up Studies ; Humans ; Hydronephrosis ; Multivariate Analysis ; Replantation ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Ureter ; Urinalysis ; Urinary Tract Infections ; Vesico-Ureteral Reflux