PURPOSE: Chemotherapies for breast cancer generally have strong cellular cytotoxicity and severe side effects. Thus, significant emphasis has been placed on combinations of naturally occurring chemopreventive agents. Silibinin is a major bioactive flavonolignan extracted from milk thistle with chemopreventive activity in various organs including the skin, prostate, and breast. However, the mechanism underlying the inhibitory action of silibinin in breast cancer has not been completely elucidated. Therefore, we investigated the effect of silibinin in MCF-7 human breast cancer cells and determined whether silibinin enhances ultraviolet (UV) B-induced apoptosis. METHODS: The effects of silibinin on MCF-7 cell viability were determined using the MTT assay. The effect of silibinin on PARP cleavage, as the hallmark of apoptotic cell death, and p53 protein expression in MCF-7 cells was analyzed using Western blot. The effect of silibinin on UVB-induced apoptosis in MCF-7 cells was analyzed by flow cytometry. RESULTS: A dose- and time-dependent reduction in viability was observed in MCF-7 cells treated with silibinin. Silibinin strongly induced apoptotic cell death in MCF-7 cells, and induction of apoptosis was associated with increased p53 expression. Moreover, silibinin enhanced UVB-induced apoptosis in MCF-7 cells. CONCLUSION: Silibinin induced a loss of cell viability and apoptotic cell death in MCF-7 cells. Furthermore, the combination of silibinin and UVB resulted in an additive effect on apoptosis in MCF-7 cells. These results suggest that silibinin might be an important supplemental agent for treating patients with breast cancer.
Apoptosis ; Blotting, Western ; Breast ; Breast Neoplasms ; Cell Death ; Cell Survival ; Humans ; MCF-7 Cells ; Milk Thistle ; Prostate ; Silymarin ; Skin

Tracheal intubation for general anesthesia is usually performed using a rigid laryngoscope and reguires the mandible to be opened with forward and upward traction of the patient's jaw which may at times result in the inadvertant injury to temporomandibular joint(TMJ). The injury may include internal derangement, dislocation and hematoma of TMJ; subsequent intraarticular adhesion formation ; dislocation of the meniscus, and rarely auriculotemporal nerve damage from traumatic TMJ dislocation. We studied in 200 patients the size of mouth opening during intubation, the change of mouth opening by tracheal intubation evaluated after operation, and any TMJ disorder arising after tracheal intubation. The results were as follows; 1) The mean size of mouth opening before operation was 42.7+/-7.0 and 40.6+/-6.2mm in male and female patients, respectively. 2) The mean size of mouth opening during intubation was 24.7+/-2.6 and 23.4+/-2.7mm in male and female patients, respectively. When vecuronium was used to prevent fasciculation, the mean was 24.3+/-3.1 and 25.2+/-2.0mm in male and female patients, respectively. 3) One week following operation The mean size of mouth opening one week postoperation was 48.3+/-8.9 and 42.2+/-6.3mm in male and female patients, respectively. When vecuronium was used to prevent fasciculation, the mean size of mouth opening was 55.5+/-5.3 and 43.2+/-6.2mm in male and female patients, respectively. 4) Five patients complained of discomfort around TMJ after tracheal intubation. It seems that upward 45 mandibule lifting by laryngoscope caused trauma to TMJs.
Anesthesia, General ; Dislocations ; Fasciculation ; Female ; Hematoma ; Humans ; Intubation ; Intubation, Intratracheal* ; Jaw ; Laryngoscopes ; Lifting ; Male ; Mandible ; Mouth ; Temporomandibular Joint Disorders ; Temporomandibular Joint* ; Traction ; Vecuronium Bromide

BACKGROUND/AIMS: We studied the prevalence of chronic hepatitis B, C and abnormality on liver function among the population in northwest area of Chungnam. METHODS: We have reviewed 40,112 adults who had received medical examination at health promotion center in Dankook university hospital. We studied them retrospectively about HBsAg, HBsAb, anti-HCV, and liver function test (LFT). RESULTS: Among the study subjects, 22,936 men and 17,176 women were involved. The overall seroprevalence of HBsAg was 4.2%. The prevalence in men (4.5%) was higher than that of women (3.7%) (p<0.001). The seroprevalence of HBsAg in their age was 5.1% in the 5th decade, 4.2% in the 2nd decade, 4.1% in the 4th decade, and 4.1% in the 6th decade. The overall seroprevalence of HBsAb was 65.1%. The overall seroprevalence of anti-HCV was 0.7%. After we reexamined them with HCV RNA or RIBA (Recombinant Immunoblot Assay), the prevalence of chronic hepatitis C was 0.09%. The LFT abnormality in total subjects was 11.4%. The LFT abnormality of chronic hepatitis B and C subjects was 21.72% and 63.2%. CONCLUSIONS: The prevalence of chronic hepatitis B and C was lower than that of previous studies. The prevalence of chronic hepatitis B in the 2nd decade was still high.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Hepatitis B Antibodies/blood ; Hepatitis B Surface Antigens/blood ; Hepatitis B, Chronic/*epidemiology/immunology/physiopathology ; Hepatitis C Antibodies/blood ; Hepatitis C, Chronic/*epidemiology/immunology/physiopathology ; Humans ; Korea ; Liver Function Tests ; Male ; Middle Aged ; Prevalence ; RNA, Viral/blood ; Retrospective Studies

Jarisch-Herxheimer reaction (JHR) is a self-limited, acute febrile hypersensitivity reaction that occurs after antibiotic therapy against spirochetes disease. When occurring in the text of syphilis therapy, the JHR begins typically 1-2 hour after the administration of penicillin and is characterized by fever, chills, myalgias, and exacerbation of skin lesions. Rarely, severe JHR can occur in the form of endocarditis, fulminant hepatitis, and hypersensitivity pneumonitis. Recently, we experienced an interesting case of JHR complicated by the hypersensitivity pneumonitis after treating secondary syphilis. Proper differential diagnosis is required to differentiate this reaction from drug-induced hypersensitivity reaction.
Alveolitis, Extrinsic Allergic ; Chills ; Diagnosis, Differential ; Endocarditis ; Fever ; Hepatitis ; Hypersensitivity ; Penicillins ; Skin ; Spirochaetales ; Syphilis

Jarisch-Herxheimer reaction (JHR) is a self-limited, acute febrile hypersensitivity reaction that occurs after antibiotic therapy against spirochetes disease. When occurring in the text of syphilis therapy, the JHR begins typically 1-2 hour after the administration of penicillin and is characterized by fever, chills, myalgias, and exacerbation of skin lesions. Rarely, severe JHR can occur in the form of endocarditis, fulminant hepatitis, and hypersensitivity pneumonitis. Recently, we experienced an interesting case of JHR complicated by the hypersensitivity pneumonitis after treating secondary syphilis. Proper differential diagnosis is required to differentiate this reaction from drug-induced hypersensitivity reaction.
Alveolitis, Extrinsic Allergic ; Chills ; Diagnosis, Differential ; Endocarditis ; Fever ; Hepatitis ; Hypersensitivity ; Penicillins ; Skin ; Spirochaetales ; Syphilis

PURPOSE: We evaluated the epidemiologic and clinical characteristics of mycoplasma pneumonia. METHODS: A total of 559 medical records of children with mycoplasma pneumonia admitted to The Catholic University of Korea, Daejeon St. Mary's Hospital, were retrospectively analyzed. RESULTS: The mean annual number of cases was 51. There was a higher occurrence in autumn (September-November, 41.7%) and in winter(26.7%). Outbreaks of mycoplasma pneumonia were noted in 1993-94, 1997, 2001, and 2003. The age distribution showed a peak frequency of 5-6 years of age and 68.2 percent of patients were in 3-8 years of age. The male-to-female ratio was 1.2:1. In comparison between 1994 and 2003, there was a difference in age distribution with a peak frequency of 5-6 years of age in 1994, and of 3-4 years of age in 2003. There were outbreaks during autumn and winter in 1993-94, and during summer and autumn in 2003. CONCLUSION: Outbreaks of mycoplasma pneumonia occurred every 2-4 years in Daejeon in accordance with nationwide epidemics during 1993-2003. The peak incidence of age in the recent outbreak was younger than in the outbreak which occurred 10 years ago, and in outbreaks in Western countries.
Age Distribution ; Child ; Disease Outbreaks ; Epidemiology ; Humans ; Incidence ; Korea ; Medical Records ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Retrospective Studies

We present the first case of enthesitis in the lumbar spine in a woman with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Enthesopathy is defined as pathological alterations at the site of insertion of a tendon, ligament, joint capsule, or fascia to bone. In particular, enthesitis is the universal hallmark of seronegative spondyloarthropathies (SpA), including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and spondyloarthropathies associated with inflammatory bowel diseases. A 36-year-old female SLE patient with a history of lupus nephritis and thrombosis from APS presented with low back pain that had been gradually worsening for several months. She reported no previous episodes of trauma. Plain radiography indicated sclerosis at the anterior superior bodies of L3 and L5. Magnetic resonance imaging (MRI) showed low-intensity lesions on T1-weighted images and high-intensity lesions on T2-weighted images at the anterior superior bodies of L3, L4, and L5, consistent with osteitis or enthesitis. A nonsteroidal antiinflammatory drug (NSAID) was used as the first-line therapy in this patient, which improved her symptoms. This is the first report of enthesitis in the context of SLE. Although the possibility of coincidental occurrence of SpA and SLE cannot be excluded, the observations in this case suggest that enthesitis may be one of the manifestations of SLE.
Adult ; Antiphospholipid Syndrome ; Arthritis, Psoriatic ; Arthritis, Reactive ; Collodion ; Fascia ; Female ; Humans ; Inflammatory Bowel Diseases ; Joint Capsule ; Ligaments ; Low Back Pain ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Magnetic Resonance Imaging ; Osteitis ; Rheumatic Diseases ; Sclerosis ; Spine ; Spondylarthropathies ; Spondylitis, Ankylosing ; Tendons ; Thrombosis

QT prolongation is a serious adverse drug effect, which is associated with an increased risk of Torsade de pointes and sudden death. Many drugs, including both cardiac and non-cardiac drugs, have been reported to cause prolongation of QT interval. Although meperidine has not been considered proarrhythmic, we present a unique case of a 16-year-old boy without an underlying cardiac disease, who developed polymorphic ventricular tachycardia, ventricular fibrillation and QT prolongation after an intravenous meperidine injection. He had no mutation in long QT syndrome genes (KCNQ1, KCNH2, and SCN5A), but single nucleotide polymorphisms were reported, including H558R in SCNA5A and K897T in KCNH2.
Adolescent ; Death, Sudden ; Heart Diseases ; Humans ; Long QT Syndrome ; Meperidine ; Polymorphism, Single Nucleotide ; Tachycardia, Ventricular ; Torsades de Pointes ; Ventricular Fibrillation

No abstract available.

Candida spondylodiscitis with epidural abscess is rarely reported and known to be the late complication of candidemia. A 48-years-old man presented with 4 weeks of progressively aggravating low back pain. He had a history of fungemia caused by Candida albicans 4 months earlier, for which he had been treated successfully with systemic fluconazole. The MRI of lumbar spine demonstrated the spondylodiscitis with multiple epidural abscesses at the L2/3 level. Along with the surgical interventions including abscess drainage, the intravenous amphotericin B administration was begun. Culture of drained pus yielded the growth of Candida albicans. After therapy with parenteral amphotericin B for 2 weeks followed by oral fluconazole for 8 weeks, the back pain resolved. However the low back pain and inflammation relapsed during oral fluconazole therapy. Thereafter oral voriconazole had been administered for 24 weeks and the patient showed complete recovery and no recurrence.
Abscess ; Amphotericin B ; Back Pain ; Candida ; Candida albicans ; Candidemia ; Discitis ; Drainage ; Epidural Abscess ; Fluconazole ; Fungemia ; Humans ; Inflammation ; Low Back Pain ; Pyrimidines ; Recurrence ; Spine ; Suppuration ; Triazoles