Although MDR was previously thought to be predominantly caused by the expression of the MDR1 gene, it is now increasingly believed to be caused by other mechanism. Recently, over-expression of the multidrug resistance-associated protein (MRP) was suggested a possible mechanism for non-Pgp mediated MDR. Recent studies showed that MRP can confer resistance to a wide spectrum of natural product drug, but the clinical relevance of MRP-mediated MDR in human cancer is poorly understood. p53 is the most widely known tumor suppressor gene. It has been suggested that mutant p53 is related to abnormal proliferation of cell and some what is been related to cellular apoptosis. To determine the clinical significance of MRP and/or p53 expression in colorectal carcinoma, the authors investigated the expression of the MRP and p53 in 81 cases of primary colorectal carcinoma, the relationship between the MRP and/or p53 expression and clinical parameters including 5-yr. survival rate, and the relationship between the expression of MRP and p53. The results were as follows: 1) Of the 81 colorectal carcinomas, 36 (42%) were MRP positive and 28 (34%) were p53 positive. 2) The expression of MRP and/or p53 was not significantly correlated with sex, age, histologic grades, tumor invasion, tumor location, tumor size, lymph node metastasis, TNM stage and survival of patients. In conclusion, these results suggest that expression of MRP and/or p53 is neither related to the known prognostic factors nor a prognostic factor by itself.
Apoptosis ; Colorectal Neoplasms* ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes ; Multidrug Resistance-Associated Proteins ; Neoplasm Metastasis ; Prognosis ; Survival Rate

PURPOSE: The surfactant dysfunction may play an important role in meconium aspiration syndrome (MAS). We aim to evaluate the effect of surfactant lavage in the treatment of term infants with MAS. METHODS: The medical records of 15 neonates with severe MAS admitted at Yongdong Severance Hospital from 2005 to 2007 were reviewed and analyzed. Seven infants with severe MAS necessitating mechanical ventilation underwent tracheobronchial lavage with 20 mL/kg of diluted (5.3 mg phospholipid/mL) surfactant saline suspension (Newfactan(R)). Data regarding clinical outcomes was assessed by comparison with 8 control infants with equally severe MAS retrospectively. RESULTS: In the lavage group, radiological improvement was evident after 6 hours of treatment. The duration of artificial ventilation and duration of hospital day were also significantly shorten in the lavage group compared with the control group. The mean oxygen index, mean ventilation index improved significantly within the first 6 hours after treatment. No differences were found in the incidence of major complications and mortality between the two groups. CONCLUSION: The surfactant lavage seems to be an effective and safe method for treatment of severe MAS. A multicenter, large scaled randomized controlled trial is needed for further study.
Bronchoalveolar Lavage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Meconium ; Meconium Aspiration Syndrome ; Medical Records ; Oxygen ; Pulmonary Surfactants ; Respiration, Artificial ; Therapeutic Irrigation ; Ventilation

PURPOSE: Inflammation plays a potential role in the pathogenesis of bronchopulmonary dysplasia (BPD). Strategies for preventing BPD include respiratory management, antioxidants, nutritional treatment, and others such as anti-inflammatory agents. We aimed to assess the safety, tolerability, and efficacy of montelukast (MK), a cysteinyl leukotriene 1 receptor antagonist, as an add-on therapy in BPD. METHODS: In addition to currently available standard measures such as oxygen supplementation, bronchodilators, nutritional support, and/or diuretics, montelukast was administered to 15 preterm infants with BPD. MK was given orally (1 mg/kg/d) for a mean period of 12 weeks. We compared safety and efficacy parameters with historical controls. RESULTS: All 15 patients survived, and no differences were found in the incidence of adverse reactions between the 2 groups. The ventilation index was significantly improved after 2 weeks in MK group compared with historical controls. There were no significant differences in other respiratory parameters (MAP, oxygen dependency, and ventilator dependency) between the groups, but the MK group showed trends of greater improvement. CONCLUSION: Administration of MK 1 mg/kg/d was well tolerated in preterm BPD patients as an add-on therapy. We demonstrated that after 2 weeks of MK administration of 1 mg/kg/d, MK had beneficial therapeutic effects on BPD patients as an add-on to the standard therapy. Further multicenter randomized controlled clinical trials are needed to confirm the efficacy and safety of MK as a useful supplement to standard therapy for BPD patients.
Acetates ; Anti-Inflammatory Agents ; Antioxidants ; Bronchodilator Agents ; Bronchopulmonary Dysplasia ; Dependency (Psychology) ; Diuretics ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Inflammation ; Nutritional Support ; Oxygen ; Quinolines ; Ventilation ; Ventilators, Mechanical

No abstract available.
Bacillus anthracis* ; Bacillus* ; Classification*

BACKGROUND: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. METHODS: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. RESULTS: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. CONCLUSIONS: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.
Humans ; Intervertebral Disc ; Interviews as Topic ; Leg ; Outpatients ; Radiculopathy ; Spinal Stenosis

A 3-year-old girl presented with polydipsia, polyuria, hyponatremia, hypertension and congestive heart failure. Her polyuria was unresponsive to water restriction and vasopressin challenge tests, and her blood pressure was not effectively controlled by antihypertensive drugs. Radiologic examinations revealed a Wilms' tumor in the right kidney. Her plasma renin activity and aldosterone concentration were greatly increased. After surgical removal of the tumor, the congestive heart failure disappeared. Congestive heart failure due to Wilms' tumor is very rare and we report here on such a case, with a brief review of the literature.
Aldosterone ; Antihypertensive Agents ; Blood Pressure ; Child, Preschool ; Estrogens, Conjugated (USP)* ; Female ; Heart Failure* ; Humans ; Hypertension* ; Hyponatremia ; Kidney ; Plasma ; Polydipsia* ; Polyuria* ; Renin ; Vasopressins ; Water ; Wilms Tumor*

BACKGROUND: The autonomic nervous system plays a critical role in triggering ventricular arrhyhmia and sudden death early after acute myocardial infarction. This study was designed to determine whether or not vagal and sympathetic responses are impaired after myocardial infarction and to evaluate the utility of physiologic stress tests for assessing autonomic dysfunction after myocardial infarction. METHODS: 8 male patients with acute myocardial infarction(Group A) and old myocardial infarction(Group B) were studied with 8 control subjects of coinciding age and sex. 5 physiologic stress tests(deep breathing, sudden standing, Valsalva maneuver, ice bag application on the face, 70degrees headd-up tilt test) were performed. RESULTS: 1) Variation in heart rate during deep breathing, Standing-up, Valsalva maneuver, and ice bag application on the face was less in Group A than in Group B or Group C. 2) There was no significant difference in variation of heart rate between Group B and Group C. 3) Variation in heart rate caused by 70degrees tilt was not significantly different among the three groups. CONCLUSION: Early after myocardial infarction, parasympathetic responses were significantly impaired, whereas sympathetic responses remained intact. Heart rate variability using physiologic stress test may be provide a means of detecting autonomic dysfunction after acute myocardial infarction.
Autonomic Nervous System* ; Death, Sudden ; Exercise Test ; Heart Rate ; Humans ; Ice ; Male ; Myocardial Infarction* ; Respiration ; Valsalva Maneuver

BACKGROUND: Shiitake dermatitis has been reported mostly from Japan and characterized by distinctive pattern of itchy skin eruption after the ingestion of raw shiitake mushrooms. OBJECTIVE: The purpose of this study is to investigate clinical, laboratory and histopathologic profiles about shiitake dermatitis occurring in Korea. METHODS: From 1997 to 2001, we had observed 58 patients with shiitake dermatitis and investigated clinical, laboratory and histopathologic aspects. RESULT: Most patients with shiitake dermatitis presented with a very strong itching sensation, which was accompanied with linearly grouped or disseminated small erythematous papules. 53 patients(91%) had noticed their skin eruption within 3 days after eating shiitake mushrooms. The involved sites were trunk, extremities, neck and face in decreasing order of frequency. Laboratory and histopathologic findings were nonspecific. In 33 patients(57%), the eruption occurred after eating boiled or panbroiled shiitake mushrooms. CONCLUSION: In this study, clinical, laboratory and histopathologic findings of shiitake dermatitis were almost consistent with the previous reports. But, contrary to the previous reports in Japan, many cases with shiitake dermatitis occurred on eating sufficiently boiled or cooked shiitake mushrooms. This may imply another eiologic factor different from thermolabile toxin.
Dermatitis* ; Eating ; Extremities ; Humans ; Japan ; Korea* ; Neck ; Pruritus ; Sensation ; Shiitake Mushrooms ; Skin

Bacillus anthracis, the etiological agent of anthrax, has been taxonomically classified into Bacillus subgroup I with B. cereus, B. mycoides, and B. thuringiensis based on their phenetic and genetic charateristics. Especially, DNA studies indicated that these species were closely related hence these species has been proposed as a single species with four subspecies. There has been controversy about taxonomy of B. anthracis isolates because none of the simple and rapid identification methods are available for closely related taxa so far. In this study, we have used VNTR analysis for reidentification of 7 strains of B. anthracis and 9 strains of closely related species. In the PCR analysis, All of the B. anthracis had a variable region of DNA sequence exception with Youngdungpo. One polymorphisms were found by the presence of four copies with the 12-bp tandem repeat sequences except Kunja. Of the closely related species, the equal size of (VNTR)' was amplified from Bacillus spp. Kyungjoo 3 and B. cereus. The sequences of Kyungjoo 3 was identical with B. anthracis. Whereas the tandem repeat sequences was not found in B. anthracis Kunja and B. cereus. Therefore, B. anthracis Kunja was finally reidentified as a B. cereus. As a results, the analysis of VNTR could be used for rapid identification for B. anthraicis from B. anthracis closely related taxa and molecular epidemiological studies of anthrax.
Anthrax ; Bacillus anthracis* ; Bacillus* ; Base Sequence ; Classification ; DNA ; Evolution, Molecular* ; Gyeongsangbuk-do ; Korea* ; Polymerase Chain Reaction ; Tandem Repeat Sequences*

Hypertrophic pachymeningitis is a rare disorder, with idiopathic, tuberculosis, syphilis and sarcoidosis being the most commonly considered etiology. We experienced a case of hypertrophic pachymeningitis caused by tuberculosis a 34-year old female. She had complained of consistent headache and diplopia for 20 days. The characteristic finding on magnetic resonance imaging was marked thickening of the unilateral cerebellar tentorium with gadolinium-DTPA enhancement. There was no significant changes on adjacent brain parenchyma. Histologic investigation of the left cerebellar tentorium disclosed chronic granulomatous inflammation with central caseous necrosis. The patient was successfully managed with anti-tuberculosis drugs.
Adult ; Brain ; Diplopia ; Female ; Headache ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Meningitis* ; Necrosis ; Sarcoidosis ; Syphilis ; Tuberculosis*