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

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

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

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

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

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.

BACKGROUND/AIMS: The liver function tests (LFTs), such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltranspeptidase (gamma-GT), have been widely used as screening tests but their low positive predictive value can cause many false positive results. To evaluate the clinical usefulness of these tests, we analyzed the serial LFT results for factory workers, and we compared the risk factors for the groups that were divided according to the serial LFT results. METHODS: From June 2001 to October 2001, 1223 consecutive healthy workers in a single factory were enrolled in our study; a questionnaire, LFT and liver ultrasonography were done for all the subjects. The previous LFT results were collected from the Annual health examination survey. According to the abnormalities on the serial LFT, the participants were classified into three groups (abnormal-in-both, alternating or, normal-in-both) and the risk factors were compared among these groups using multiple logistic regression analysis. RESULTS: The prevalence of LFT abnormality on a single test was 16.8%, but on the serial LFT, only 5% of the study participants showed consistent abnormality. The risk factors for the abnormal-in-both group, compared with the alternating group, were liver ultrasonography abnormality such as a fatty liver (odds ratio, 2.2; P=0.026) and a heavy alcohol intake (more than 210 g/week) (odds ratio, 7.2; P=0.064). HBsAg was not a significant risk factor for any of the three groups. CONCLUSIONS: In factory workers having serial LFT abnormalities, alcoholic liver disease could be the principal cause of abnormal LFT. Even if the HBsAg were positive in patients with abnormal LFT, there is the possibility of another causes for LFT abnormalities such as alcoholic liver disease and non-alcoholic steatosis or steatohepatitis.
Adult ; English Abstract ; Female ; Humans ; Korea ; Liver/*enzymology ; Liver Diseases/*diagnosis ; *Liver Function Tests ; Male ; Middle Aged ; Occupational Health Services ; Risk Factors

PURPOSE: Despite a development fo therapeutic machines and advance in modern radiation therapy techniques, locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate. Combination of chemotherapy and radiotherapy demonstrated benefit in improving local control and possibly the overall survival. Our study was performed to evaluate effect of concurrent chemoradiation on locally advanced uterine cervical cancer. METHODS AND MATERIALS: Twenty six patients with locally advanced stage(FIGO stage IIB with > or = 5 cm in diameter, III, IVA) were treated with combination of radiation therapy and concurrent cisplatinum between May of 1988 and Septermber of 1993 at our hopital. Radiation therapy consisted of external irradiation and 1-2 sessions of intracavitary irradiation, Cisplatinum was administered in bolus injection of 25mg/m(2) at weekly intervals during the course of external radiation therapy. RESULTS: Of the 26 patients, twenty-five patients were evaluable for estimation of response. Median follow-up period was 25 months with ranges from 3 to 73 months. Stage IIB, III, and IVA were 16, 5,4 patients, respectively. Twenty patients were squamous cell carcinoma. Response was noted in all 25 patients: complete response(CR) in 17/25(68%), partial response(PR) in 8/25(32%). Of the 24 patients except one who died of sepsis at 3 months follow-up, seventeen patients(70.8%) maintained local control in the pelvis: 16/17(94.1%) in CR, 1/17(14.3%) in PR. Fourteen of the 17 patients with CR are alive disease free on the completion of follow-up. Median survival is 28 months for CR and 15 months for PR. Analysis of 5-year survival by stage shows 11/16(59.8) in IIB, 3/5(60.6%) in III, and 1/4(25.0%) in IVA. Overall 5-year survival rate was 55.2%. Ten Patients recurred: 4 at locoegional,3 in distant metastasis and 3 with locoregional and distant site. Toxicity by addition of cisplatinum was not excessive. CONCLUSION: Although the result of this study was obtained from small number of patients, it is rather encouraging in view of markedly improved response rate compared with the results of historical group.
Carcinoma, Squamous Cell ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Pelvis ; Radiotherapy ; Sepsis ; Survival Rate ; Uterine Cervical Neoplasms*

Light chain deposition disease (LCDD) is a systemic disorder characterized by the deposition of monoclonal immunoglobulin light chains (LCs) in various organs. As LCs are overproduced by an abnormal clone of B cells, LCDD is usually described in the course of plasma cell dyscrasias or other lymphoproliferative disorders. However, it can occur in the absence of any detectable hematological disorder even during prolonged follow-up. We experienced a case of 62-year-woman who presented generalized edema, massive proteinuria and renal insufficiency. The histologic findings showed nodular glomerular mesangial expansion and prominent ribbon like immunohistochemical staining for kappa-light chain in the glomerular capillary wall. There was no evidence of multiple myeloma in bone marrow biopsy specimen. Because she refused the intensive chemothrapy, low dose of prednisolone and cyclophosphamide were prescribed for 6 months. Her renal function was maintained relatively well without renal replacement therapy for 7 months. We report a case of idiopathic LCDD not associated with multiple myeloma or other plasma cell dysclasia.
B-Lymphocytes ; Biopsy ; Bone Marrow ; Capillaries ; Clone Cells ; Cyclophosphamide ; Edema ; Follow-Up Studies ; Immunoglobulin Light Chains ; Lymphoproliferative Disorders ; Multiple Myeloma ; Nephrotic Syndrome ; Paraproteinemias ; Plasma Cells ; Prednisolone ; Proteinuria ; Renal Insufficiency ; Renal Replacement Therapy