BACKGROUND: Platelet-activating factor (PAF) induces nuclear factor (NF)-kappaB activation and angiogenesis and increases tumor growth and pulmonary tumor metastasis in vivo. The role of NF-kappaB activation in PAF-induced angiogenesis in a mouse model of Matrigel implantation, and in PAF-mediated pulmonary tumor metastasis were investigated. METHODS: Angiogenesis using Matrigel and experimental pulmonary tumor metastasis were tested in a mouse model. Electrophoretic mobility shift assay was done for the assessment of NF-kappaB translocation to the nucleus. Expression of angiogenic factors, such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1alpha, basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) were tested by RT-PCR and ELISA. RESULTS: PAF induced a dose- and time-dependent angiogenic response. PAF-induced angiogenesis was significantly blocked by PAF antagonist, CV6209, and inhibitors of NF-kappaB expression or action, including antisense oligonucleotides to p65 subunit of NF-kappaB (p65 AS) and antioxidants such as alpha-tocopherol and N-acetyl-L-cysteine. In vitro, PAF activated the transcription factor, NF-kappaB and induced mRNA expression of TNF-alpha, IL-1alpha, bFGF, VEGF, and its receptor, KDR. The PAF-induced expression of the above mentioned factors was inhibited by p65 AS or antioxidants. Also, protein synthesis of VEGF was increased by PAF and inhibited by p65 AS or antioxidants. The angiogenic effect of PAF was blocked when anti-VEGF antibodies was treated or antibodies against TNF-alpha, IL-1alpha, and bFGF was co-administrated, but not by antibodies against TNF-alpha, IL-1alpha, and bFGF each alone. PAF-augmented pulmonary tumor metastasis was inhibited by p65 AS or antioxidants. CONCLUSION: These data indicate that PAF increases angiogenesis and pulmonary tumor metastasis through NF-kappaB activation and expression of NF-kappaB-dependent angiogenic factors.
Acetylcysteine ; alpha-Tocopherol ; Angiogenesis Inducing Agents ; Animals ; Antibodies ; Antioxidants ; Electrophoretic Mobility Shift Assay ; Enzyme-Linked Immunosorbent Assay ; Fibroblast Growth Factor 2 ; Interleukins ; Mice ; Neoplasm Metastasis* ; NF-kappa B ; Oligonucleotides, Antisense ; RNA, Messenger ; Transcription Factors ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

Background: The purpose of this study was to establish effective measures and preventive managements to the cases of bloodborne exposures among the health care workers. Method: We reviewed 331 cases that were reported to the infection control services of five hospitals from March 2000 to February 2002. The SPSS PC 10.0 was used to analyze the date. Result: The proportion of registered nurses, doctors, housekeepers, unrse aid and technicians were 48.0%, 27.8%, 10.0%, 6.0%, and 5.4% in order. The proportion of female exposures was 75.2%. Fifty six point eight percent of exposure have been working less than 3 years. The data also indicated that there were differences by their Occupations. Thirty nine point six percent of the exposures occurred at the general ward, and 16.6% of them occurred at the operation room and 13.0% of them occurred at the intensive care unit. Most of the bloodborne exposures occurred during blood sampling (26.3%), putting away the needle including the recapping(18.4%). and giving injection (14.5%). The major instruments of exposures were syring-needle (79.6%), blade (7.3%), suture needle (6.1%), and direct contact with blood (2.7%). The hands were the most common body parts of exposures (95.2%). The bloodborne pathogens were hepatitis B virus (HBV, 38.1%(126/331), hepatitis C virus (10.3%), syphilis (4.5%), and human immuno-dificiency virus (2.7%). Forty one point three percent(52/127) of health care workers(HCWs) usually didn't realize whether they had antibody to the HBV or not at the time of exposure; Seventy five percent (39/52) of them found out later to be positive for HBV antibody. Only 48.7% (19/39) of them could get the medical treatment since they didn't know about immunity before the test. The cases with completion of management at the time of exposure, those of follow-up evaluations, and the cases with lost follow-up were 40.7%, 38.6% and 20.7%. in order. None of the cases were led to actual infections. Conclusion: The results from this study can be applied to establish effective measures of prevention and managements of the bloodborne exposures among the HCWs. If the laboratory data of HCWs were available at the time of exposure, more effective management would be possible. Also the results from this study emphasized the need for the systematic and practical follow-up.
Blood-Borne Pathogens ; Delivery of Health Care* ; Female ; Follow-Up Studies ; Gyeonggi-do* ; Hand ; Hepacivirus ; Hepatitis B virus ; Human Body ; Humans ; Infection Control ; Intensive Care Units ; Needles ; Occupations ; Patients' Rooms ; Seoul* ; Sutures ; Syphilis

Purpose: The purpose of this study is to determine the risk adjusted nosocomial infection (NI) rate and distribution of Nls and their causative pathogens in adult lCU. Methods: Prospective surveillance was performed at 12 lCU's of 5 acute care hospitals in Seoul and Kyonggi Do during a 3-months period from May to July 2002. The case finding was done by direct reviews of medical charts regularly for all patients by ICPs using CDC definitions. Results: Total NI rate was 10.18/1,000 patient-days in Medical-surgical ICU (MSICU) and 12.35/1,000 patient-days in Neurosurgucal ICU(NCI). Risk adjusted infection rate was 3.44 in indwelling catheter associated UTI 2.12 in central line associated BSI. 3.51/1,000 device-days in ventilator associated pneumonia in MSICU. There were 3.72, 2.26, 6.06/1,000 device-days in NCU. The infection rate by leu type showed no significant difference. The distribution of Nls were PNEU (28.99%). UTI (28.99%), BSI (18,84%), SSI(4.35%) in MSICU, and UTI(48.0%), PNEU(24.0%), BSI (14.0%), SSI(6.I) in NCU. The most commonly isolated organisms were Candida spp (38.6%), Enterococcus spp. (13.4%) in UTI, Staphylococcus aureus(36.2%), p. aeruginosa(18.8%) in PNEU and Coagulase negative staphylococcus(44.1%). S. aureus (14.7%) in BSL, S. aureus (19.8%) was the most common organism from overall nosocomial infections in the ICU, and 96.3% of S. aureus were MRSA. Conclusion: Distribution of site-specific nosocomial infection and isolated organisms were similar to the results of KOSNIC (Korea society for nosocomial infection control) surveillance in 1996. However, the total infection rate and a risk adjusted infection rate at MSJCU is lower than 1996's. This decrease is considered to be a result of efforts to prevention and control nosocomial infections.
Adult ; Candida ; Catheters, Indwelling ; Centers for Disease Control and Prevention (U.S.) ; Coagulase ; Cross Infection* ; Enterococcus ; Gyeonggi-do ; Humans ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Seoul ; Staphylococcus

BACKGROUND AND OBJECTIVES: Since 1987, coronary stents have changed the pattern of practice of interventional cardiology, by reducing the complications and improving the clinical outcomes. However, coronary stent restenosis still remains a significant clinical problem in the field of interventional cardiology. The aim of this trial was to compare the clinical efficacy of a rotational atherectomy (ROTA), with that of a plain old balloon angioplasty (POBA), in patients with coronary stent restenosis. SUBJECTS AND METHODS: One hundred and three patients (men 80, 58.4+/-10.3 years of age), diagnosed with coronary stent restenosis, at Chonnam National University Hospital, between January 1999 and December 2000, were analyzed. The clinical end-points were the occurrence of major adverse cardiac events (MACE): death, myocardial infarction and target lesion revascularization (TLR) during the one-year clinical follow-up. RESULTS: The baseline clinical and angiographic characteristics were similar between the two groups. Before the percutaneous coronary intervention (PCI), the diameter of stenosis of the POBA and ROTA groups were 81.9+/-14.0 and 82.9+/-10.0%, respectively, which decreased to 25.5+/-15 and 22.7+/-12% after treatment. At the one-year clinical follow-up, the TLR rates were 7.0 and 6.3% in the POBA and ROTA groups, respectively. The MACE results were not different between the two groups (7.0 and 9.4% in the POBA and ROTA groups, respectively). CONCLUSION: There was no significant long-term clinical benefit of a rotational atherectomy prior to a POBA, compared with a POBA alone, for the treatment of coronary stent restenosis.
Angioplasty ; Angioplasty, Balloon* ; Atherectomy, Coronary* ; Cardiology ; Constriction, Pathologic ; Follow-Up Studies* ; Humans ; Jeollanam-do ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stents*

The active metabolite of vitamin D, 1,25-dihydroxyvitamin D3 (calcitriol), inhibits the growth of several types of human cancer cells in vitro, but its therapeutic use is limited because it causes hypercalcemia. Among its analogs, 19-nor-1,25-dihydroxyvitamin D2 (paricalcitol), has fewer calcemic effects and exhibits an activity equipotent to that of calcitriol. We assessed the antitumor and anti-inflammatory effects of paricalcitol in gastric cancer cells, and evaluated the potential role of vitamin D in the treatment of peritoneal metastatic gastric cancer. In this study, treatment with paricalcitol inhibited gastric cancer cell growth and induced cell cycle arrest. Paricalcitol also induced apoptosis and showed anti-inflammatory activity. Moreover, the growth of intraperitoneal metastases in vivo was reduced in mice treated with paricalcitol. 18F-FDG uptake was significantly lower in the paricalcitol group compared to control group (SUV; control group 13.2 +/- 5.3 vs paricalcitol group 4.5 +/- 3.0). Intraperitoneal tumor volume was significantly lower in paricalcitol treated mice (control group 353.2 +/- 22.9 mm3 vs paricalcitol group 252.0 +/- 8.4 mm3). These results suggest that the vitamin D analog, paricalcitol, has anticancer activity on gastric cancer cells by regulation of the cell cycle, apoptosis, and inflammation.
Animals ; Antineoplastic Agents/chemistry/*pharmacology/therapeutic use ; Apoptosis/drug effects ; Cell Cycle Checkpoints/drug effects ; Cell Cycle Proteins/metabolism ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Disease Models, Animal ; Ergocalciferols/chemistry/*pharmacology/therapeutic use ; Fluorodeoxyglucose F18/chemistry/diagnostic use ; Humans ; Mice ; Mice, Inbred BALB C ; Peritoneal Neoplasms/drug therapy/*secondary ; Positron-Emission Tomography ; Stomach Neoplasms/drug therapy/*pathology ; Transplantation, Heterologous

The familial occurrence of a pituitary adenoma associated with multiple endocrine neoplasia (MEN) type 1 or Carney complex is a well-recognized entity. However, an isolated familial somatotropinoma is a rare inherited disease, which is characterized by clustering of a somatotrophic adenoma and acromegaly or gigantism in a family, but without other manifestations of MEN type 1, with only 68 cases, in 28 families, described in the literature. The mode of inheritance is autosomal dominant, with incomplete penetration, but the genetic background of these pituitary adenomas remains unknown. A family exists where both the father and son were affected. Endocrinological investigations confirmed hypersecretion of GH and IGF-1, and the pituitary adenomas were identified by magnetic resonance image in both cases. There was no symptom of MEN type 1 or other form of endocrine dysfunction. Herein is reported a case of an isolated familial somatotropinoma in Korea, with a review of the literature
Acromegaly ; Adenoma ; Carney Complex ; Fathers ; Gigantism ; Growth Hormone-Secreting Pituitary Adenoma* ; Humans ; Insulin-Like Growth Factor I ; Korea ; Male ; Multiple Endocrine Neoplasia ; Pituitary Neoplasms ; Somatotrophs ; Wills

The familial occurrence of a pituitary adenoma associated with multiple endocrine neoplasia (MEN) type 1 or Carney complex is a well-recognized entity. However, an isolated familial somatotropinoma is a rare inherited disease, which is characterized by clustering of a somatotrophic adenoma and acromegaly or gigantism in a family, but without other manifestations of MEN type 1, with only 68 cases, in 28 families, described in the literature. The mode of inheritance is autosomal dominant, with incomplete penetration, but the genetic background of these pituitary adenomas remains unknown. A family exists where both the father and son were affected. Endocrinological investigations confirmed hypersecretion of GH and IGF-1, and the pituitary adenomas were identified by magnetic resonance image in both cases. There was no symptom of MEN type 1 or other form of endocrine dysfunction. Herein is reported a case of an isolated familial somatotropinoma in Korea, with a review of the literature
Acromegaly ; Adenoma ; Carney Complex ; Fathers ; Gigantism ; Growth Hormone-Secreting Pituitary Adenoma* ; Humans ; Insulin-Like Growth Factor I ; Korea ; Male ; Multiple Endocrine Neoplasia ; Pituitary Neoplasms ; Somatotrophs ; Wills

A 28-year old male presented with chest pain of two hours duration. He had histories of 10 years smoking and 2 years of nephrotic syndrome, due to minimal change disease. His EKG showed marked ST segment elevations in the V3-6, I, II, III and aVF leads. The levels of cardiac enzymes were increased (CK: 481 U/l, CK-MB: 96 U/l and Troponin I: 4.8 ng/mL). The prothrombin and activated partial promboplastin times were normal. Accelerated tissue type plasminogen activator (100 mg) was administered at the emergency room, but his chest pain continued, with persistent ST segment elevations. An urgent coronary angiograph revealed huge multiple filling defects, suggestive of thrombi in the proximal left anterior descending artery (LAD), with thrombolysis in the myocardial infarction (TIMI) flow. A rescue percutaneous coronary intervention was performed using repeated angioplasties with a 3.0 mm balloon. However, the filling defects and distal LAD flow did not improve. We administered Abciximab (ReoPro(r)), and the LAD flow improved to a TIMI III flow, with resolution of the thrombus in the LAD. His clinical course was uneventful after discharge, and a left coronary angiogram, at the 6-month follow-up, showed no filling defects, with the TIMI III flow maintained.
Adult ; Angioplasty ; Arteries ; Blood Platelets ; Chest Pain ; Electrocardiography ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction* ; Nephrosis, Lipoid ; Nephrotic Syndrome* ; Percutaneous Coronary Intervention ; Prothrombin ; Smoke ; Smoking ; Thrombosis ; Tissue Plasminogen Activator ; Troponin I

We report a case of tacrolimus-induced transplant-associated thrombotic microangiopathies (TA-TMA) after lung transplantation. A 71-year-old man underwent lung transplantation secondary to idiopathic pulmonary fibrosis. After 4 months, he presented with abdominal discomfort and dyspnea, and was diagnosed with hemolytic anemia and thrombocytopenia. Tacrolimus was considered the cause of the TMA. Tacrolimus was stopped and several sessions of plasma exchange were performed immediately after diagnosis of TA-TMA. However, his platelet count did not normalize, gastrointestinal bleeding was recurrent, and severe pneumonia developed, following which he died. TA-TMA are rare but severe, life-threatening complications in lung transplant recipients. Therefore, the possibility of TA-TMA should be considered in posttransplant recipients.
Aged ; Anemia, Hemolytic ; Diagnosis ; Dyspnea ; Hemorrhage ; Humans ; Idiopathic Pulmonary Fibrosis ; Lung Transplantation* ; Lung* ; Plasma Exchange ; Platelet Count ; Pneumonia ; Tacrolimus ; Thrombocytopenia ; Thrombotic Microangiopathies* ; Transplant Recipients

A 55-year old male presented with chest and abdominal pain for four hours. One day prior to admission he had received chemotherapeutic agents comprising 130 mg cisplatin and 5,200 mg 5-Fluorouracil for nasopharyngeal carcinoma. EKG showed ST elevations in the leads II, III and aVF. The levels of cardiac enzymes were elevated [creatine kinase (CK) 1129 U/L, CK-MB 180 U/L, troponin T 1.23 ng/mL and troponin I 23.29 ng/mL]. Urokinase was administered at the emergency room, but the patient's chest pain continued with persistent ST segment elevations. Urgent coronary and renal angiograms revealed thrombotic occlusive lesions in the distal right coronary and right renal arteries. Percutaneous transluminal renal angioplasty using 6.0x20 mm balloon was performed for the renal artery. However, filling defects and distal renal flow were not improved and so Abciximab (ReoPro(r)) was administered. Follow-up coronary and renal angiograms on the fifth hospital day showed no filling defects with good distal flow in both right coronary and renal arteries.
Abdominal Pain ; Angioplasty ; Chest Pain ; Cisplatin* ; Electrocardiography ; Emergency Service, Hospital ; Fluorouracil* ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; Phosphotransferases ; Renal Artery* ; Thorax ; Thrombosis* ; Troponin I ; Troponin T ; Urokinase-Type Plasminogen Activator