No abstract available.

Functional paraganglioma of the mediastinum is an uncommon tumor of the paraganglion system that causes symptoms and signs of episodic catecholamine release. It has not been reported in Korea. We experienced a case of a 17 years old man with a history of diaphoresis and paroxysmal hypertension refractory to therapy since 14 years old. Urinary execretion of catecholamine and its metabolites were elevated. Computed tomography(CT) scan revealed high density mass located on the posterior mediastinum in the area of the right fifth intercostal space. At thoracotomy, a 3X3X4cm sized lesion was resected and confirmed as a paraganglioma.
Adolescent ; Humans ; Hypertension* ; Korea ; Mediastinum* ; Paraganglioma* ; Pheochromocytoma ; Thoracotomy

Toll-like receptors (TLRs) are the best-characterized membrane-bound receptors in innate immune cells, including macrophages and dendritic cells. Upon recognition of specific ligands originating from pathogen- and modified self-derived molecules, TLRs trigger intracellular signaling cascades that involve various adaptor proteins and enzymes, resulting in the generation of proinflammatory and antimicrobial responses through the activation of transcription factors such as nuclear factor-kappaB. TLR-dependent signaling pathways are tightly regulated during innate immune responses by a variety of negative regulators. This review focuses on the newly described regulation of TLR-dependent signaling pathways, and emphasizes the roles of TLRs in innate immunity. Efforts to modulate these regulatory pathways and signaling molecules may result in the development of new therapeutic strategies through TLR-based therapy.
Dendritic Cells ; Immunity, Innate ; Ligands ; Macrophages ; Proteins ; Toll-Like Receptors ; Transcription Factors

PURPOSE: The commonly accepted diagnostic algorithm for hematuria includes excretory urography (IVU) and cystoscopy at a urologic department. The clinical courses was determined and a less invasive algorithm for young male patients with asymptomatic microscopic hematuria is suggested. MATERIALS AND MTHODS: A total of 310 males with an asymptomatic microscopic hematuria were enrolled retrospectively in the study at our clinic between January 1997 and December 2000. The mean age of the patients was 20.9 years (range 19 to 25). The initial urologic evaluation consisted of a urinalysis. If the results of the initial urologic evaluation were within the normal range, a cystoscopic examination was recommended as a further evaluation. Ninety-two patients underwent a cystoscopy. All patients were followed by urinalysis. The grade of microscopic hematuria with persistency, and the detection rate of abnormal findings in urologic evaluation were compared. RESULTS: There was a relationship between the grade of hematuria and the rate of the persistency of hematuria, but no relationship between the grade of hematuria and the detection rate of abnormal findings in a urologic evaluation was found. The results of the excretory urography and ultrasound showed an interdependence. There were no significant findings in the cystoscopic examination. CONCLUSIONS: A periodical follow-up of urinalysis is a proper study for young male patients with asymptomatic microscopic hematuria. In order to rule out upper urinary tract diseases, ultrasound and excretory urography can be useful. Furthermore, it is recommended that cystoscopy be done for selected cases in young male patients.
Cystoscopy ; Follow-Up Studies ; Hematuria* ; Humans ; Male* ; Reference Values ; Retrospective Studies ; Ultrasonography ; Urinalysis ; Urography ; Urologic Diseases

PURPOSE: The commonly accepted diagnostic algorithm for hematuria includes excretory urography (IVU) and cystoscopy at a urologic department. The clinical courses was determined and a less invasive algorithm for young male patients with asymptomatic microscopic hematuria is suggested. MATERIALS AND MTHODS: A total of 310 males with an asymptomatic microscopic hematuria were enrolled retrospectively in the study at our clinic between January 1997 and December 2000. The mean age of the patients was 20.9 years (range 19 to 25). The initial urologic evaluation consisted of a urinalysis. If the results of the initial urologic evaluation were within the normal range, a cystoscopic examination was recommended as a further evaluation. Ninety-two patients underwent a cystoscopy. All patients were followed by urinalysis. The grade of microscopic hematuria with persistency, and the detection rate of abnormal findings in urologic evaluation were compared. RESULTS: There was a relationship between the grade of hematuria and the rate of the persistency of hematuria, but no relationship between the grade of hematuria and the detection rate of abnormal findings in a urologic evaluation was found. The results of the excretory urography and ultrasound showed an interdependence. There were no significant findings in the cystoscopic examination. CONCLUSIONS: A periodical follow-up of urinalysis is a proper study for young male patients with asymptomatic microscopic hematuria. In order to rule out upper urinary tract diseases, ultrasound and excretory urography can be useful. Furthermore, it is recommended that cystoscopy be done for selected cases in young male patients.
Cystoscopy ; Follow-Up Studies ; Hematuria* ; Humans ; Male* ; Reference Values ; Retrospective Studies ; Ultrasonography ; Urinalysis ; Urography ; Urologic Diseases

The nuclear receptor superfamily consists of the steroid and non-steroid hormone receptors and the orphan nuclear receptors. Small heterodimer partner (SHP) is an orphan family nuclear receptor that plays an essential role in the regulation of glucose and cholesterol metabolism. Recent studies reported a previously unidentified role for SHP in the regulation of innate immunity and inflammation. The innate immune system has a critical function in the initial response against a variety of microbial and danger signals. Activation of the innate immune response results in the induction of inflammatory cytokines and chemokines to promote anti-microbial effects. An excessive or uncontrolled inflammatory response is potentially harmful to the host, and can cause tissue damage or pathological threat. Therefore, the innate immune response should be tightly regulated to enhance host defense while preventing unwanted immune pathologic responses. In this review, we discuss recent studies showing that SHP is involved in the negative regulation of toll-like receptor-induced and NLRP3 (NACHT, LRR and PYD domains-containing protein 3)-mediated inflammatory responses in innate immune cells. Understanding the function of SHP in innate immune cells will allow us to prevent or modulate acute and chronic inflammation processes in cases where dysregulated innate immune activation results in damage to normal tissues.
Chemokines ; Child ; Child, Orphaned ; Cholesterol ; Cytokines ; Glucose ; Humans ; Immune System ; Immunity, Innate ; Inflammasomes ; Inflammation ; Metabolism ; Orphan Nuclear Receptors ; Social Control, Formal ; Toll-Like Receptors

No abstract available.
Humans ; Korea ; Quality-Adjusted Life Years ; Stroke

Tuberculosis (TB) remains a worldwide health problem, causing around 2 million deaths per year. Despite the bacillus Calmette Guerin vaccine being available for more than 80 years, it has limited effectiveness in preventing TB, with inconsistent results in trials. This highlights the urgent need to develop an improved TB vaccine, based on a better understanding of host-pathogen interactions and immune responses during mycobacterial infection. Recent studies have revealed a potential role for autophagy, an intracellular homeostatic process, in vaccine development against TB, through enhanced immune activation. This review attempts to understand the host innate immune responses induced by a variety of protein antigens from Mycobacterium tuberculosis, and to identify future vaccine candidates against TB. We focus on recent advances in vaccine development strategies, through identification of new TB antigens using a variety of innovative tools. A new understanding of the host-pathogen relationship, and the usefulness of mycobacterial antigens as novel vaccine candidates, will contribute to the design of the next generation of vaccines, and to improving the host protective immune responses while limiting immunopathology during M. tuberculosis infection.
Autophagy ; BCG Vaccine ; Host-Pathogen Interactions ; Immunity, Innate ; Mycobacterium tuberculosis ; Tuberculosis* ; Vaccines

Although tuberculosis poses a significant health threat to the global population, it is a challenge to develop new and effective therapeutic strategies. Nitric oxide (NO) and inducible NO synthase (iNOS) are important in innate immune responses to various intracellular bacterial infections, including mycobacterial infections. It is generally recognized that reactive nitrogen intermediates play an effective role in host defense mechanisms against tuberculosis. In a murine model of tuberculosis, NO plays a crucial role in antimycobacterial activity; however, it is controversial whether NO is critically involved in host defense against Mycobacterium tuberculosis in humans. Here, we review the roles of NO in host defense against murine and human tuberculosis. We also discuss the specific roles of NO in the central nervous system and lung epithelial cells during mycobacterial infection. A greater understanding of these defense mechanisms in human tuberculosis will aid in the development of new strategies for the treatment of disease.
Bacterial Infections ; Central Nervous System ; Defense Mechanisms ; Epithelial Cells ; Humans ; Immunity, Innate ; Lung ; Macrophages ; Mycobacterium tuberculosis ; Nitric Oxide ; Nitric Oxide Synthase ; Nitrogen ; Tuberculosis

Among a number of innate receptors, the nucleotide-binding domain leucine-rich repeat containing (NLR) nucleotide oligomerization domain (NOD)-like receptor families are involved in the recognition of cytosolic pathogen- or danger-associated molecules. Activation of these specific sets of receptors leads to the assembly of a multiprotein complex, the inflammasome, leading to the activation of caspase-1 and maturation of the cytokines interleukin (IL)-1beta, IL-18, and IL-33. Among NLRs, NLR-related protein 3 (NLRP3) is one of the best-characterized receptors that activates the inflammasome. There is no doubt that NLRP3 inflammasome activation is important for host defense and effective pathogen clearance against fungal, bacterial, and viral infection. In addition, mounting evidence indicates that the NLRP3 inflammasome plays a role in a variety of inflammatory diseases, including gout, atherosclerosis, and type II diabetes, as well as under conditions of cellular stress or injury. Here, we review recent advances in our understanding of the role of the NLRP3 inflammasome in host defense and various inflammatory diseases.
Atherosclerosis ; Cytokines ; Cytosol ; Defense Mechanisms ; Gout ; Humans ; Inflammasomes ; Inflammation ; Interleukin-18 ; Interleukins