Colorectal cancer is rare in teenagers, especially without known risk factors. Colon cancer in young age is more likely to be diagnosed at advanced-stage, to present unfavorable tumor histology such as mucinous carcinoma, and poor outcome. We report a case of sporadic mucinous adenocarcinoma of the colon in a 19-year-old male patient without any risk factors. He complained of severe left abdominal pain that developed 1 month ago. He had a distended abdomen with severe tenderness on the left lower quadrant. A distal descending colon mass causing mechanical obstruction was observed on abdominal computed tomography. Emergency colonoscopy showed a large, fungating mass obstructing the lumen at 40 cm from the anal verge. Biopsy of the colonic mass suggested a mucinous adenocarcinoma. After decompression by colonic stent, the patient was transferred to the general surgery department for left hemicolectomy. The lesion was confirmed to be a mucinous adenocarcinoma (7.0x4.5 cm). For hereditary nonpolyposis colorectal cancer evaluation, immunohistochemical staining for MLH1 and MSH2 was normal. Reverse transcription polymerase chain reaction analysis did not detect microinstability in any of the markers tested. The patient had no familial history of cancer. Mucinous adenocarcinoma has high frequencies of poor differentiation, advanced tumor stage, loss of mismatch repair gene expression, and increased MUC2 expression. A mucinous histology is considerably more frequent in children and adolescent than in adults. Adequate invasive study is also necessary for young age patients.
Abdomen ; Abdominal Pain ; Adenocarcinoma, Mucinous ; Adolescent ; Adult ; Biopsy ; Child ; Colon ; Colon, Descending ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis ; Decompression ; DNA Mismatch Repair ; Emergencies ; Gene Expression ; Humans ; Male ; Mucins ; Polymerase Chain Reaction ; Reverse Transcription ; Risk Factors ; Stents ; Young Adult

BACKGROUND: The incidence of atherosclerosis is well correlated with the progression of type 2 diabetes mellitus. High plasma glucose in uncontrolled diabetic patients evokes many vascular complications such as atherosclerosis. Specifically, high glucose was reported to induce thrombospondin-1 (TSP-1), which activates matrix metalloproteinase-2 (MMP-2) and leads to the invasion of vascular smooth muscle cells (VSMCs) into the intima. Catechins with antioxidant effects are known to inhibit MMP-2 activity. Therefore, this study was aimed at revealing the effect of epicatechin, one of catechins, on high glucose-induced TSP-1 and the invasiveness of VSMCs. METHODS: VSMCs were primarily isolated from Sprague-Dawley rat aorta. The VSMCs were incubated with different doses (30, 100 and 300 micrometer) of epicatechin under high glucose concentration (30 mM). The TSP-1 protein and mRNA expressions were analyzed by performing Western blotting and Northern blot analyses, respectively. RT-PCR was performed to observe the MMP-2 mRNA expression. Gelatin zymography was performed for the measurement of MMP-2 activity. Invasion assays were performed to evaluate the invasiveness of VSMCs. RESULTS: Epicatechin inhibited the high glucose-induced TSP-1 expression and the MMP-2 activity in a dose-dependent manner. Also, epicatechin inhibited the high glucose-induced invasiveness of VSMCs across the matrix barrier in a dose-dependent fashion. CONCLUSION: Collectively, epicatechin may prevent the high glucose-induced proliferation and invasion of VSMCs by inhibiting the TSP-1 expression and the MMP-2 activity. Therefore, epicatechin appears to play a protective role in the development of atherosclerosis.
Animals ; Antioxidants ; Aorta ; Atherosclerosis ; Blood Glucose ; Blotting, Northern ; Blotting, Western ; Catechin* ; Diabetes Mellitus, Type 2 ; Gelatin ; Glucose ; Humans ; Incidence ; Matrix Metalloproteinase 2 ; Muscle, Smooth, Vascular* ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Thrombospondin 1*

BACKGROUND: The incidence of atherosclerosis is well correlated with the progression of type 2 diabetes mellitus. High plasma glucose in uncontrolled diabetic patients evokes many vascular complications such as atherosclerosis. Specifically, high glucose was reported to induce thrombospondin-1 (TSP-1), which activates matrix metalloproteinase-2 (MMP-2) and leads to the invasion of vascular smooth muscle cells (VSMCs) into the intima. Catechins with antioxidant effects are known to inhibit MMP-2 activity. Therefore, this study was aimed at revealing the effect of epicatechin, one of catechins, on high glucose-induced TSP-1 and the invasiveness of VSMCs. METHODS: VSMCs were primarily isolated from Sprague-Dawley rat aorta. The VSMCs were incubated with different doses (30, 100 and 300 micrometer) of epicatechin under high glucose concentration (30 mM). The TSP-1 protein and mRNA expressions were analyzed by performing Western blotting and Northern blot analyses, respectively. RT-PCR was performed to observe the MMP-2 mRNA expression. Gelatin zymography was performed for the measurement of MMP-2 activity. Invasion assays were performed to evaluate the invasiveness of VSMCs. RESULTS: Epicatechin inhibited the high glucose-induced TSP-1 expression and the MMP-2 activity in a dose-dependent manner. Also, epicatechin inhibited the high glucose-induced invasiveness of VSMCs across the matrix barrier in a dose-dependent fashion. CONCLUSION: Collectively, epicatechin may prevent the high glucose-induced proliferation and invasion of VSMCs by inhibiting the TSP-1 expression and the MMP-2 activity. Therefore, epicatechin appears to play a protective role in the development of atherosclerosis.
Animals ; Antioxidants ; Aorta ; Atherosclerosis ; Blood Glucose ; Blotting, Northern ; Blotting, Western ; Catechin* ; Diabetes Mellitus, Type 2 ; Gelatin ; Glucose ; Humans ; Incidence ; Matrix Metalloproteinase 2 ; Muscle, Smooth, Vascular* ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Thrombospondin 1*

PURPOSE: p63 is a recently described as p53 homologue. Despite their structural homologies, they have different activities. p63 is a specific myoepithelial cell marker in normal breast tissue and it is expressed in a minority of breast cancers. The aim of this study was to evaluate the prognostic significance of the p63 expression in breast cancer. METHODS: The expression of p63 in breast cancer was determined by performing immunohistochemistry on 350 patients who underwent mastectomy at the Department of Surgery at Korea University Medical Center between January 1992 and September 2004. A retrospective analysis was conducted using the medical records. A tissue microarray was constructed, and immunohistochemical analysis for p63 was performed according to the usual methods. RESULTS: Among 350 patients, 40 (11.4%) showed a p63 expression. There was a significant correlation between p63 and the histologic grade. There were significant correlations of p63 with p53 and HER2/neu, respectively. In the basal type of breast cancer, the p63 expression was significantly higher than in the luminal type of breast cancer. The 5 year disease free survival rates were 69% in the patients with a p63 expression and 76% in the patients without a p63 expression, but there was no statistical difference. CONCLUSION: The present results indicate that a p63 expression is associated with a high grade tumor, a p53 expression and a HER2/neu expression in breast cancer, which are the known poor prognostic factors of breast cancer. Immunohistochemical subtyping shows that the p63 expression is a useful predictor for the basal type of breast cancer. In addition, this study suggests that the p63 expression in the basal type of breast cancer is associated with a poor prognosis.
Academic Medical Centers ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Korea ; Mastectomy ; Medical Records ; Phenobarbital ; Prognosis ; Retrospective Studies

No abstract available.

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is the most accurate modality in diagnosis of choledocholithiasis. However, it carries some complications. Endoscopic ultrasonography (EUS) is less invasive than ERCP and used for the diagnosis of choledocholithiasis. Recent studies showed that a usefulness of EUS for the diagnosis of small choledocholithiasis without common bile duct (CBD) dilatation. For such a reason, ERCP is being replaced by EUS in the diagnosis of bile duct stones. The aim of this study was to investigate the accuracy of EUS for the diagnosis of choledocholithiasis without CBD dilatation. METHODS: A total of 66 patients with suspected choledocholithiasis without CBD dilatation were enrolled. EUS were performed in all cases within 48 hours after computed tomography (CT) or ultrasonography (US). Final diagnosis was obtained by ERCP or clinical course (minimum 6 months follow-up). We analyzed the accuracy of US, CT, and EUS, respectively. RESULTS: CT and US were performed in 51 and 15 cases, respectively. CBD stones were detected in 23 (35%) patients by ERCP. EUS showed 100% sensitivity, 95% specificity, 92% positive predictive value, and 100% negative predictive value for identifying CBD stones. CT or US showed 26%, 93%, 67%, and 70%, respectively. There were no EUS-related complications. CONCLUSIONS: EUS was more effective than CT or US and as accurate as ERCP for the diagnosis of small choledocholithiasis without CBD dilatation. Thus, EUS may help to avoid unnecessary diagnostic ERCP and its complication.
Adult ; Aged ; Aged, 80 and over ; Choledocholithiasis/pathology/*ultrasonography ; Common Bile Duct Diseases/diagnosis ; Diagnosis, Differential ; Dilatation, Pathologic/diagnosis ; *Endosonography ; Female ; Gallstones/ultrasonography ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, X-Ray Computed

BACKGROUND: Infiltration of eosinophils in the nasal mucosa is a consistent feature of nasal allergic inflammation. Various cytokines, especially interleukin-5(IL-5), were identified to play important roles in the infiltration and activation of eosinophils in nasal mucosa. Our previous study found that among 4 kinds of sophoricosides extracted from Sophora japonica, named sophi, orobol, genistin, and genistein, 3 compounds except genistein known as protein tyrosine kinase(PTK) inhibitor had anti-inflammatory and anti-IL-5 effects, and sophi was the most potent. OBJECTIVE: The goal of this study was to investigate the antagonism of sophi on the nasal eosinophilia in ovalbumin(OA)-sensitized murine nasal allergy model. METHODS: Male BALB/c mice sensitized intraperitoneally and then topically with OA were treated with sophi(10 or 30mg/kg) or anti-mouse IL-5 monoclonal antibody(anti-IL-5 mAb, 1mg/Kg) intravenously 1 hour before challenge. The effect of sophi on the infiltration of eosinophils into the nasal mucosa, peripheral blood eosinophilia, nasal symptom, and OA-specific IgE antibody production were evaluated. Results: Administration of sophi(10, 30mg/kg) significantly inhibited the nasal eosinophil infiltration and nasal symptom compared to that of anti-IL-5 mAb. But eosinophil count inthe peripheral blood and the titer of OA-specific IgE were not affected by sophi. CONCLUSION: Sophi inhibited not only the tissue eosinophilia but also the acute nasal allergic symptom. These findings suggest that sophi has anti-eosinophilic cytokine activity and also plays blockade of early allergic reaction. Taken together, sophi may be a candidate for new anti-allergic medicine.
Animals ; Antibody Formation ; Cytokines ; Eosinophilia ; Eosinophils* ; Genistein ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Inflammation ; Interleukin-5 ; Male ; Mice ; Nasal Mucosa ; Sophora ; Tyrosine

BACKGROUND: It has been hypothesized that early atherosclerosis may be related to the pathogenesis of coronary vasospasm. This study was designed to investigate the relationship between early atherosclersosis and coronary vasospasm or vasoconstriction in response to axetylcholine utilizing intravascular ultrasonography. METHOD: Total 43 segments were analyzed from subjects who were composed of 10 patients with and 7 patients without coronary vasospasm in response to intra coronary acetylcholine infusion. Spasm segment(Sp) was defined as total or subtotal occlusion, constriction segment(C) as diameter decrease>/=10%, and normal segment(N) as diameter decrease<10% compared to baseline coronary angiogram. Atherosclerotic plaque thickness was defined as the sum of thickness of intimal leading edge and sonolucent zone. Atherosclerosis was defined as atherosclerotic plaque thickness > 0.5mm. RESULTS: The atherosclerotic plaques of spasm segments were significantly thicker than those of normal and constriction segments(spasm segments : 1.19+/-0.21mm, constrict segments : 0.58+/-0.11mm, normal segment : 0.37+/-0.11, p<0.05). Atherosclerosis was present in 90% of spasm segments. Among normal of constriction segments, atherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm, although it was statistically insignificant(patients with vasospasm : 0.65+/-0.51mm, patients without vasospasm 0.36+/-0.39mm, p=0.07). Frequency of atherosclerosis in normal or constriction segments was significantly higher in patients with vasospasm than patients without vasospasm(patients with vasospasm 47%, patients without vasospasm : 11%, p<0.05). CONCLUSION: Atherosclerosis is present at segments of vasospasm in response to intracoronary acetylcholine. Even among normal or constriction segments, the artherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm which may indicates that coronary vasospasm is a diffuse early atherosclerotic disease.
Acetylcholine ; Atherosclerosis ; Constriction ; Coronary Vasospasm* ; Humans ; Plaque, Atherosclerotic ; Spasm ; Ultrasonography* ; Ultrasonography, Interventional ; Vasoconstriction*

An 84-year-old woman presented with obstructive jaundice due to unresectable gallbladder cancer with a left renal cell carcinoma. Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD) were unsuccessful because of tumor obstruction of the duodenal bulb, right hepatic duct and distal common bile duct. Endoscopic ultrasound (EUS)-guided biliary drainage with a transgastric approach was performed. A guide-wire was passed through the biliary obstruction and was successfully advanced into the duodenum via the ampulla. The procedure was completed in an antegrade fashion. The obstructed biliary system was successfully decompressed by the insertion of a biliary covered metal stent through the malignant stricture. There were no complications related to the use of this procedure.
Aged, 80 and over ; Biliary Tract ; Carcinoma, Renal Cell ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Constriction, Pathologic ; Drainage ; Duodenum ; Female ; Gallbladder Neoplasms ; Hepatic Duct, Common ; Humans ; Jaundice ; Jaundice, Obstructive ; Stents

BACKGROUND/AIMS: Pancreatic acini of streptozotocin (STZ)-induced diabetic rats release amylase less than normal acini on cholecystokinin (CCK) stimulation. Pancreatic enzyme secretion has been closely related to the intracellular calcium concentration ([Ca2+]i) of the acinar cell. In the present study, sequential changes of the intracellular calcium signal which probably underlie the altered enzyme secretion in response to CCK-8 were investigated using pancreatic acini from diabetic rats. METHODS: Diabetic rats were prepared by single intravenous injection of STZ (70 mg/kg). Stimulating experiments with CCK-8 were performed 7 days later. Pancreatic acini were isolated by collagenase digestion. Amylase release and [Ca2+]i were measured by colorimethod and calcium imaging, respectively. The geometry of intracellular calcium signal was analyzed. RESULTS: Normal acini exhibited concentration-dependent [Ca2+]i increase and regular oscillatory calcium signal on CCK-8 stimulation. Amylase release was also concentration-dependent. However, diabetic acini showed significantly less [Ca2+]i increase, prolonged time to peak [Ca2+]i, decreased calcium spikes number, and decreased amylase release compared with normal acini. The decreased [Ca2+]i in diabetic acini was restored significantly by insulin treatment. CONCLUSIONS: Relatively decreased amylase release in diabetic pancreatic acini in response to CCK, appears to be associated with altered calcium signal due to insulin deficiency.
Amylases/*secretion ; Animals ; Calcium Signaling/*drug effects ; Diabetes Mellitus, Experimental/*physiopathology ; Pancreas/cytology/metabolism/*secretion ; Rats ; Rats, Sprague-Dawley ; Sincalide/*pharmacology