T cell activation is a critical event for initiation and regulation of immune responses and inhibitors of such signaling pathways are clinically useful for the treatment of patients received allogratt and autoimmune disease. In the course of screening soil microorganisms from the forest of Cheju island in Korea for new immunosuppressive agent, one of Streptomyces species (CK-95441) was found to produce a new immunosuppressant, tautomycetin which also had antifungal activity. Tautomycetin showed the inhibition of T cell proliferation in murine mixed lymphocyte reaction (MLR) and T cell activation induced by concanavalin A. Tautomycetin also blocked the induction of IL-2 gene expression which was examined in Jurkat TAg cell line in which multiple NFAT-binding sites and minimal IL-2 promoter drive the production of B-galactosidase. Also, the level of inhibition in activation-induced IL-2 receptor expression by tautomycetin was greater than those by cyclosporin A measured by flow cytometry. But, Fas ligand-induced apoptosis in Jurkat cells was unaffected by tautomycetin which was measured by DNA fragmentation assay. These results suggested that tautomycetin will be able to be used as a potent immunosuppressive drug following organ transplantation.

The optimal treatment of primary or metastatic liver cancer is the complete surgical excision of the tumors. Hepatoma has a poor prognosis, especially in the case of unresectable hepatoma. In such cases, variable therapeutic modalities have been tried in attempts to improve the prognosis of the hepatoma patients. One of these modalities is hepatic cryosurgery, which has received increased attention recently. We have experienced four cases of hepatic cryosurgery on unresectable hepatomas at the ChungAng University Hospital in Korea, the first such cases, from September 1995 to December 1995. There was an excellent therapeutic outcome in one case. We expect that hepatic cryosurgery will serve as a new and effective therapeutic modality for unresectable hepatoma.
Carcinoma, Hepatocellular ; Cryosurgery* ; Humans ; Korea ; Liver Neoplasms ; Prognosis

The systematic study of products from bacteria and fungi has led to the development of two immunosuppressive drugs, cyclosporin A and FK 506 (tacrolimus) which are useful to suppress adaptive immune responses to the grafted tissue. However, they affect all immune responses indiscriminately and are both toxic to kidneys and other organs. To facilitate the development of immunosuppressor to block the T cell receptor (TcR)-mediated signaling cascade specifically, a novel Jurkat T cell transfectants, JK NFAT-SEAP were generated in which the expression of the secreted alkaline phosphatase (SEAP) is driven by the multiple NFAT binding sites plus minimal IL-2 promoter. Upon stimulation with ionomycin or anti-TcR mAb OKT3 in the presence of PMA, these transfectants secreted high level of SEAP into the medium, which was conveniently analyzed by SEAP analysis. The secretion of SEAP was effectively inhibited by cyclosporin A or FK 506 at the concentration of [10 ' ug/ml], [10 ug/ml] respectively. JK NFAT-SEAP transfectants will provide two major advantages for the development of a novel immunosuppressor. First, analysis of SEAP secreted into the culture medium by SEAP analysis enables us to test a large number of samples within a short period of time. Second, Usage of IL-2 promoter for the expression of SEAP makes us identify bioproducts to target specifically on TcR-mediated signaling pathway.
Alkaline Phosphatase ; Bacteria ; Binding Sites ; Cell Line* ; Cyclosporine ; Fungi ; Interleukin-2 ; Ionomycin ; Kidney ; Mass Screening* ; Muromonab-CD3 ; Receptors, Antigen, T-Cell ; T-Lymphocytes* ; Tacrolimus ; Transplants

OBJECTIVE: The purpose of this study is to investigate the results of treatment using stent-angioplasty for symptomatic middle cerebral arterial (MCA) stenosis and comparison of in-stent restenosis between drug-eluting stents (DES), bare metal coronary stents (BMS) and self-expanding stents (SES). MATERIALS AND METHODS: From Jan. 2007 to June. 2012, 34 patients (mean age +/- standard deviation: 62.9 +/- 13.6 years) with MCA stenosis were treated. Inclusion criteria were acute infarction or transient ischemic attacks (TIAs) and angiographically proven symptom related severe stenosis. Stents used for treatment were DES (n = 8), BMS (n = 13) and SES (n = 13). National Institutes of Health Stroke Scale (NIHSS) at admission was 2.5 +/- 3.1 and mean stenosis rate was 79.0 +/- 8.2%. Assessment of clinical and angiographic results was performed retrospectively. RESULTS: Among 34 patients, periprocedural complications occurred in four cases (11.8%), however, only two cases (6.0%) were symptomatic. All patients were followed clinically (mean follow-up period; 40.7 +/- 17.7 months) and 31 were followed angiographically (91.2%. 13.4 +/- 8.5 months). There was no occurrence of repeat stroke in all patients; however, mild TIAs related to restenosis occurred in three of 34 patients (8.8%). The mean NIHSS after stent-angioplasty was 1.7 +/- 2.9 and 0.8 +/- 1.1 at discharge. The modified Rankin score (mRS) at discharge was 0.5 +/- 0.9 and 0.3 +/- 0.8 at the last clinical follow-up. In-stent restenosis over 50% occurred in five of 31 angiographically followed cases (16.1%), however, all of these events occurred only in patients who were treated with BMS or SES. Restenosis rate was 0.0% in the DES group and 20.8% in the other group (p = 0.562); it did not differ between BMS and SES (2/11 18.2%, 3/13 23.1%, p = 1.000). CONCLUSION: Stent-angioplasty appears to be effective for symptomatic MCA stenosis. As for restenosis, in our study, DES was presumed to be more effective than BMS and SES; meanwhile, the results did not differ between the BMS and SES groups.
Angioplasty ; Constriction, Pathologic ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Infarction ; Ischemic Attack, Transient ; Middle Cerebral Artery ; National Institutes of Health (U.S.) ; Stents ; Stroke

OBJECTIVES: We investigated the relationship between bone mineral density (BMD) and hormone therapy (HT) and its duration in postmenopausal women. METHODS: We performed a retrospective study on 291 postmenopausal women who had their BMD and follow-up BMD measured in a university hospital. We analyzed BMD, HT types and HT duration according to clinical characteristics. RESULTS: The mean age of the study subjects was 53.7 +/- 5.9 years. HT types and HT duration were not statistically related to improvement in BMD (P = 0.956, 0.483). But osteoporosis in patients with hormone therapy improves bone mineral density showed statistical significance (P = 0.001). CONCLUSION: HT types and HT duration did not have any effect on bone mineral density, but further prospective multicenter studies regarding HT should be considered for osteoporosis.
Bone Density ; Female ; Follow-Up Studies ; Humans ; Osteoporosis ; Retrospective Studies

Fibroepithelial polyps (FEPs) on the vulvovaginal region are rare lesions of the lower genital track and differential diagnosis can be wide. When faced with FEPs, gynecologists and pathologists have to consider a wide range of diagnoses, because overlapping morphologic features and management of these lesions has been observed. We report a case of fibroepithelial polyps that developed on an unusual genital site, and provide a brief review of the literature.
Diagnosis, Differential ; Polyps ; Polytetrafluoroethylene ; Track and Field

Women undergo various physical changes because of hormonal changes occurring after menopause. Some representative changes caused by the reduction in estrogen levels in these women are dyslipidemia, abnormal lipoprotein levels, obesity, weight gain, and changes in body fat distribution. A characteristic of women approaching menopause is the shift of fat from their hips and thighs to their abdomen. Notably, fat accumulation is common in internal organs, resulting in male-pattern obesity among women approaching menopause; therefore, these women require more exercise therapy than premenopausal women to prevent and treat obesity. To the best of our knowledge, no effective exercise therapy guidelines have been established for postmenopausal women; therefore, I aimed to suggest more effective diet and exercise therapies for postmenopausal women with obesity. For this purpose, I organized the diet and exercise protocol by collaborating with an obstetrician and a researcher specializing in sports medicine; further, this protocol was actually applied to all participants. The results indicated that the protocol is effective in reducing weight; however, joint pain was commonly noted in participants who dropped out of the program. Based on the evaluation of joint pain, this study found that it is necessary to perform exercise therapy by avoiding weight-bearing activities and reinforcing personalized joint strengthening exercises because reduced estrogen level is an important factor exacerbating arthritis in postmenopausal women.

Salmonella infection is an acute systemic disease that can lead to diffuse organ involvement with septicemia and cause clinically a variety of complications. But acute acalculous cholecystitis and acute hepatitis with jaundice due to Salmonella typhi occurred rarely. A 42 years old female was admitted with fever, chilling sensation and abdominal pain. On admission, the blood, stool, bile acid and bone marrow cultures were positive for Salmonella typhi. The patient had subsequently developed acute acalculous cholecystitis and acute hepatitis with jaundice. Her symptoms and signs resolved after cholecystostomy, parenteral antibiotic (ciprofloxacin) and supportive treatment. We report a case of acute acalculous cholecystitis and acute hepatitis with jaundice in a 42-ear-ld female, whose conditions were recovered completely after cholecystostomy and administration of ciprofloxacin, with reviewing the literatures.
Abdominal Pain ; Acalculous Cholecystitis* ; Adult ; Bile ; Bone Marrow ; Cholecystostomy ; Ciprofloxacin ; Female ; Fever ; Hepatitis* ; Humans ; Jaundice ; Salmonella Infections ; Salmonella typhi* ; Salmonella* ; Sensation ; Sepsis

OBJECTIVES: The aim of the present study was to determine the prevalence of osteopenia and osteoporosis in women aged 20 years and older in Gumi province. METHODS: We recruited a total of 2,347 women aged 20 years and older in Gumi province who visited the health care center in Soonchunhyang University Gumi hospital from January 2010 to December 2011. The bone mineral densities in the calcaneus were measured by an ultrasound bone densitometry. Osteoporosis and osteopenia were defined by World Health Organization criteria. Age-specific prevalence of osteoporosis and osteopenia in Gumi province were determined and compared with the prevalence of osteoporosis and osteopenia from other provinces within Korea. The prevalence of each was described by %. RESULTS: Age-specific prevalence of osteoporosis was less than 2% in women younger than 50 years but it rapidly increased in those older than 55 years and up to about 50% in women older than 70 years. The prevalence of osteoporosis in women in Gumi province was lower than that of Kangwon province. However, its results were higher than Jung-up province. In addition, the prevalence of osteoporosis in women in Gumi province was lower than other provinces including: Gang-hwa, Chun-cheon, Chung-ju, Jungnang and Gangseo in Seoul, Korea Health Statistics 2009. CONCLUSION: The age-specific prevalence of osteoporosis in women in Gumi province increased with ages, especially in those older than 55 years. Also, the prevalence of osteoporosis in women in Gumi province was lower than Kangwon and other provinces within Korea as stated by Korea Health Statistics 2009. However, its results were higher than Jung-up province.
Aged ; Bone Density ; Bone Diseases, Metabolic ; Calcaneus ; Delivery of Health Care ; Densitometry ; Female ; Humans ; Korea ; Osteoporosis ; Prevalence ; World Health Organization

BACKGROUND/AIMS: Balloon dilatation is a useful alternative to surgery in patients with benign pyloric stenosis. However, little data are available on the long-term outcome of the procedure. This report was attempted to determine the safety and efficacy of endoscopic balloon dilatation for 14 patients with gastric outlet obstruction caused by duodenal ulcer. METHODS: Review of medical records or telephone interview was performed retrospectively. RESULTS: Follow-up was conducted for median 18.5 months (3-48 months). Gastric outlet strictures had a median diameter 6 mm (range, 2-9 mm). Five (35.7%) patients had active ulcer. 12 mm to 18 mm balloons were inflated a median of 1 times (range, 1-4 times) for a median of 4 minutes (range, 1-11 minutes). Thirty-two procedure (1.5/patient) were performed; 9 patients (64.3%) had one treatment and 5 patients (35.7%) had multiple treatment. Immediate symptomatic relief was achieved in 13 patients (92.8%) and 7 patients (50%) achieved sustained symptomatic relief. Dilatation failed only in 2 patients (14.3%) ultimately and both recovered by palliative bypass surgery. No complication was noted during treatment. CONCLUSIONS: Endoscopic balloon dilatation is safe and effective for most patients with gastric outlet obstruction induced by duodenal ulcer. And due to limitation of retrospective aspect of this report, further prospective, randomized studies must be performed.
Constriction, Pathologic* ; Dilatation* ; Duodenal Ulcer ; Follow-Up Studies ; Gastric Outlet Obstruction ; Humans ; Interviews as Topic ; Medical Records ; Pyloric Stenosis ; Retrospective Studies ; Ulcer