Loss of heterozygosity (LOH) has been established as an important genetic mechanism giving rise to malignant neoplasia. The mechanism of LOH has been shown to cause basal cell carcinoma and malignant melanoma as well as other types of skin cancer. A few studies on LOH in sporadic keratoacanthomas have been reported. The purpose of this study was to investigate the significance of LOH in the pathogenesis of sporadic keratoacanthomas developed in 10 Korean patients. The presents of LOH at 7 microsatellite markers (D2S286, D3S1317, D5S346, D9S160, D9S171, D10S185, and D17S261) were evaluated in sporadic keratoacanthomas. LOH was found in only 1 of 10 cases at D10S185. The low frequency of LOH detected in this study suggests that LOH may not be significant in the induction of sporadic keratoacanthomas.
Adult ; Aged ; Female ; Humans ; Keratoacanthoma/*genetics ; *Loss of Heterozygosity ; Male ; Middle Aged ; Research Support, Non-U.S. Gov't

BACKGROUND AND OBJECTIVES: The recovery of the left ventricular ejection fraction (LVEF) appeared to be prognostic of survival in congestive heart failure (CHF). The aim of our study was to evaluate the parameters that appear to predict the LVEF recovery in CHF. SUBJECTS AND METHODS: Forty-nine patients, with CHF and a LVEF< 35%, were enrolled. Doppler myocardial imaging was performed on 5-basal and 5-mid segments in order to assess the systolic duration, the time from the R-wave to the peak systolic velocity (RS time) and the time from the R-wave to the peak early diastolic velocity (RE time). The standard deviation (SD) of the RS time was an indicator of the 'systolic synchronicity'. After at least 3 months of full medical therapy, a follow-up echocardiography was performed. According to the changes in the LVEF, the patients were divided into groups I (< 5%, n=29) and II (> or =5%, n=20). RESULTS: The baseline clinical and echocardiographic parameters were similar in both groups. In group II, the LV end-systolic and end-diastolic volumes were decreased, but the LVEF was increased by up to 44% at the follow-up. The right ventricular annulus velocity (group I: 6.7+/-2.1 vs. group II: 8.0+/-2.0 cm/sec, p< 0.05), the use of beta-blocker (69 vs. 100%, p< 0.05) and the SD of the RS time (46+/-21 vs. 21+/-12, p< 0.01) were significantly different between the two groups. However, the systolic duration and the SD of the RE time were similar in the two groups. From a multivariate analysis, only the SD of the RS time was an independent predictor of the LVEF recovery. CONCLUSION: Myocardial systolic synchronicity is an important predictor of the LVEF recovery.
Echocardiography ; Estrogens, Conjugated (USP)* ; Follow-Up Studies ; Heart Failure* ; Heart Ventricles* ; Humans ; Multivariate Analysis ; Recovery of Function* ; Stroke Volume

PURPOSE: To evaluate the efficacy of a modified small bowel follow-through (SBFT) and to optimize this technique. MATERIALS AND METHODS: Ninety-nine subjects without small bowel pathology underwent modified SBFT using oral administration of methylcellulose after taking 100ml of 120% or 100, 150, or 200ml of 70% barium. Thirty-three and 39 normal subjects undergoing enteroclysis or conventional SBFT, respectively, were also evaluated for comparison of image qualities and transit time. RESULTS: Enteroclysis was the most successful ofthree types of small bowel examination for obtaining the best quality of bowel transradiency and distension. Modified SBFT was, however much superior to the conventional series for obtaining good bowel transradiency and rapid transity time (mean, 37-49 minutes). The use of 150ml of 70% barium was better than the other three modified techniques in achieving good bowel transradiency, rapid transit time, and less flocculation. CONCLUSION: Our modified SBFT is a simple and safe method for easily improving bowel transradiency and transit time.
Administration, Oral ; Barium ; Flocculation ; Methylcellulose* ; Pathology

Proteasomes are the primary degradation machinery for oxidatively damaged proteins that compose a class of misfolded protein substrates. Cellular levels of reactive oxygen species increase with age and this cellular propensity is particularly harmful when combined with the age-associated development of various human disorders including cancer, neurodegenerative disease and muscle atrophy. Proteasome activity is reportedly downregulated in these disease conditions. Herein, we report that docosahexaenoic acid (DHA), a major dietary omega-3 polyunsaturated fatty acid, mediates intermolecular protein cross-linkages through oxidation, and the resulting protein aggregates potently reduce proteasomal activity both in vitro and in cultured cells. Cellular models overexpressing aggregation-prone proteins such as tau showed significantly elevated levels of tau aggregates and total ubiquitin conjugates in the presence of DHA, thereby reflecting suppressed proteasome activity. Strong synergetic cytotoxicity was observed when the cells overexpressing tau were simultaneously treated with DHA. Antioxidant N-acetyl cysteine significantly desensitized the cells to DHA-induced oxidative stress. DHA significantly delayed the proteasomal degradation of muscle proteins in a cellular atrophy model. Thus, the results of our study identified DHA as a potent inducer of cellular protein aggregates that inhibit proteasome activity and potentially delay systemic muscle protein degradation in certain pathologic conditions.
Atrophy ; Cells, Cultured ; Cysteine ; Humans ; In Vitro Techniques* ; Muscle Fibers, Skeletal* ; Muscle Proteins ; Muscular Atrophy* ; Neurodegenerative Diseases ; Oxidative Stress ; Proteasome Endopeptidase Complex* ; Protein Aggregates* ; Reactive Oxygen Species ; Ubiquitin

Right internal jugular vein is preferred for central venous catheter insertion because of fewer complications. However, insertion-related complications can occur such as arterial puncture, pneumothorax, and hemothorax. Arrhythmia can also occur, but it has been reported to temporarily occur only during guidewire insertion. We report a case of symptomatic paroxysmal atrial fibrillation induced by right internal jugular venous catheterization for hemodialysis. The chest X-ray taken after insertion of the catheter showed that the catheter was advanced too deeply into right atrium from an unusually lower puncture site. The atrial fibrillation persisted nearly 24 hours and was corrected by removal of the catheter. We experienced that paroxysmal atrial fibrillation can be complicated by central venous catheterization, and appropriate selection of puncture site and catheter length is important to avoid it.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Catheterization* ; Catheterization, Central Venous ; Catheters* ; Central Venous Catheters ; Heart Atria ; Hemothorax ; Jugular Veins ; Pneumothorax ; Punctures ; Renal Dialysis* ; Thorax

BACKGROUND/AIMS: The prevalence of occult HBV infection depends on the prevalence of HBV infection in the general population. Hemodialysis patients are at increased risk for HBV infection. The aim of this study was to determine the prevalence of occult HBV infection in hemodialysis patients. METHODS: Total of 98 patients undergoing hemodialysis in CHA Bundang Medical Center (Seongnam, Korea) were included. Liver function tests and analysis of HBsAg, anti-HBs, anti-HBc and anti-HCV were performed. HBV DNA testing was conducted by using two specific quantitative methods. RESULTS: HBsAg was detected in 4 of 98 patients (4.1%), and they were excluded. Among 94 patients with HBsAg negative and anti-HCV negative, one (1.1%) patient with the TaqMan PCR test and 3 (3.2%) patients with the COBAS Amplicor HBV test were positive for HBV DNA. One patient was positive in both methods. Two patients were positive for both anti-HBs and anti-HBc and one patient was negative for both anti-HBs and anti-HBc. CONCLUSIONS: The present study showed the prevalence of occult HBV infection in HBsAg negative and anti-HCV negative patients on hemodialysis at our center was 3.2%. Because there is possibility of HBV transmission in HBsAg negative patients on hemodialysis, more attention should be given to prevent HBV transmission.
Adult ; Aged ; Aged, 80 and over ; Antibodies/blood ; DNA, Viral/analysis ; Feces/*virology ; Female ; Hepatitis B/complications/*epidemiology/transmission ; Hepatitis B Core Antigens/immunology ; Hepatitis B virus/genetics/immunology ; Hepatitis C Antibodies/blood ; Humans ; Kidney Failure, Chronic/*complications/diagnosis ; Male ; Middle Aged ; Polymerase Chain Reaction ; Prevalence ; Renal Dialysis ; Risk Factors

Primary angiitis of the central nervous system (PACNS) is a poorly understood form of vascular inflammatory disease that is restricted to the brain and spinal cord. A 38-year-old woman presented with severe headache and transient aphasia. Her cerebrospinal fluid exhibited aseptic meningitis, and high-resolution vessel-wall MRI (HRVW-MRI) revealed narrowing of multiple intracranial vessels with concentric wall thickening and diffuse enhancement, suggestive of PACNS. High-dose steroid and azathioprine therapy resulted in a significant improvement in vessel wall thickening, and enhancement was observed on the follow-up HRVW-MRI.
Adult ; Aphasia ; Azathioprine ; Brain ; Central Nervous System* ; Cerebrospinal Fluid ; Female ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging* ; Meningitis, Aseptic ; Spinal Cord ; Vasculitis* ; Vasculitis, Central Nervous System

For a potentially malignant lymphadenopathy, it is clinically important to distinguish between metastasis of a primary tumor and a benign lesion such as systemic sarcoidosis or sarcoid reaction. We describe here a case of systemic sarcoidosis that was associated with early gastric cancer. A patient was found to have early gastric cancer (EGC) during routine clinical examination. The chest radiography demonstrated bilateral hilar lymphadenopathy and further examination showed that he had multiple lymphadenopathies. We diagnosed systemic sarcoidosis with EGC because of the elevated serum ACE-I, the chest CT findings and the pathological analysis. We performed endoscopic submucosal dissection (ESD) for EGC, and there was no local recurrence and distant metastasis for eighteen months. These findings suggest that the possibility of systemic sarcoidosis should be considered in cases with established malignancy and multiple lymphadenopathies.
Humans ; Lymphatic Diseases ; Neoplasm Metastasis ; Recurrence ; Sarcoidosis ; Stomach Neoplasms ; Thorax

BACKGROUND: Direct measurements of ionized magnesium (iMg) in serum by ion-selective electrodes have recently become available in clinical practice, and its usefulness needs to be investigated in dialysis patients because chronic renal failure is associated with disturbances in magnesium metabolism. METHODS: We measured serum iMg in 29 hemodialysis (HD) patients and 24 peritoneal dialysis (CAPD) patients using an ion-selective electrode. The results were compared with those from 30 age- matched control patients who were admitted due to non-renal diseases and were confirmed to have normal serum total magnesium (tMg) levels. RESULTS: Serum tMg was significantly higher in both HD (0.95 [0.81-1.06] mmol/L) and CAPD (0.86 [0.74-0.99] mmol/L) patients compared with the controls (0.74 [0.70-0.78] mmol/L). Serum iMg was significantly higher in HD patients (0.65 [0.60-0.72] mmol/L) compared with the controls (0.55 [0.51-0.57] mmol/L), but was not higher in CAPD patients (0.54 [0.50-0.60] mmol/L). Thus, the ionized fraction of serum magnesium (iMg/tMg) was significantly lower in CAPD patients (65.3 [58.8-68.2]%), but not in HD patients (68.7 [63.6-77.0]%), compared with the controls (72.2 [67.2-78.3]%). In dialysis patients, iMg/ tMg was significantly lower in those with residual renal function than in anuric patients (67.5 [63.6-74.8]% vs. 61.4 [56.4-70.7]%). CONCLUSION: In current practice, true hypermagnesemia may exist frequently in HD patients (at predialysis), but not in CAPD patients. The ionized fraction of serum magnesium may be reduced in CAPD patients, but not in HD patients.
Dialysis* ; Humans ; Ion-Selective Electrodes ; Kidney Failure, Chronic ; Magnesium* ; Metabolism ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis

BACKGROUND: Vancomycin-resistant enterococci (VRE) are multi-drug resistant organisms that have emerged as important nosocomial pathogens in recent years. Patients with burn injury are highly vulnerable to VRE infection. We evaluated the colonization and infection rate of VRE among severe burn patients. MATERIALS AND METHODS: We retrospectively reviewed VRE isolation in a tertiary hospital burn center from January 2000 to December 2003. We analyzed and compared the clinical characteristics of VRE colonized (isolated in rectal swab) and infected patients. We also analyzed the risk factors of mortality in VRE infection group by using univariate and multivariate analyses. RESULTS: VRE was isolated from 104 of severe burn patients. Mean percent of total body surface area of 104 patients was 45.43+/-22.15%. The most commonly isolated VRE was Enterococcus faecium (82.6%). The VRE infection rate of VRE colonization group was 19/93 (20.4%). There were no differences in clinical characteristics, underlying conditions, and isolates species between VRE colonization and infection groups. The mortality rate of VRE infection group was 40%. The risk factors for mortality were bacteremia (P=0.001) and mechanical ventilation (P=0.024) in univariate analysis. However, independent risk factor for death was only VRE bacteremia [odd ratio=32.803, 95% confidence interval (2.884, 373.129), P=0.005] in multivariate analysis. CONCLUSION: Significant portion of severe burn patients with VRE colonization could progress to VRE infection. Severe burn patients with VRE bacteremia have higher risk of death than patients without VRE bacteremia.
Bacteremia ; Body Surface Area ; Burn Units ; Burns* ; Colon ; Enterococcus ; Enterococcus faecium ; Humans ; Mortality* ; Multivariate Analysis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors* ; Tertiary Care Centers ; Vancomycin Resistance