BACKGROUND: c-erbB-1 (epidermal growth factor receptor) and c-erbB-2 oncoprotein have common tyrosine kinase activities, and alteration in their expression has been defined in various visceral tumors. However, relatively little is known about their expression in skin tumors. OBJECTIVE: Our aim was to evaluate the distribution and expression pattern of c-erbB-1 and c-erbB-2 in skin neoplasms. METHODS: We have undertaken an immunohistochemical survey of c-erbB-1 and c-erbB-2 in the tissue specimens of keratoacanthoma (KA), actinic keratosis (AK), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). RESULTS: Membranous c-erbB-1 expression had a tendency to be down-regulated in some specimens of SCC and dysplastic portions of AK. In invasive lesions of SCC, we observed increased cytoplasmic accumulation of c-erbB-1. Most specimens of BCC showed rather decreased expression of c-erbB-1 compared with other skin tumors. c-erbB-2 oncoprotein showed strong cytoplasmic staining in SCC, especially in the invasive tumor mass, and in some deeply dysplastic or hyperplastic portions of AK, though the difference of intensity was not striking between tumors. BCC revealed relatively weaker expression of c-erbB-2 than other skin tumors, which was similar in pattern to c-erbB-1. CONCLUSION: The expression patterns of c-erbB-1 and c-erbB-2 are altered in various skin neoplasms, and seem to be related to the dysplastic status or differentiation level of tumor cells.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cytoplasm ; Keratoacanthoma ; Keratosis, Actinic ; Protein-Tyrosine Kinases ; Skin Neoplasms ; Skin* ; Strikes, Employee

Necrotizing fasciitis, first described by Wilson in 1952, is one of the most dramatic infectious diseases which develops at the level of superficial fascia and involves the overlying dermis. Clinical diagnosis is often initially confused with cellulitis, and delay in the diagnosis and treatment is associated with high mortality in the range from 30% to 70%. Early diagnosis and prompt excision of all devitalized tissue are critical because any remaining necrotic tissue will continue the rapidly progressive infectious process. We, herein, report a 64-year-old man who was presented with a typical clinical course of necrotizing fasciitis.
Cellulitis ; Communicable Diseases ; Dermis ; Diagnosis ; Early Diagnosis ; Fasciitis, Necrotizing* ; Humans ; Middle Aged ; Mortality ; Subcutaneous Tissue

Although the peritoneum is rare site for a primary neoplasm, certain malignant neoplasms may arise from it. A case of 63-year-old woman who had a serous papillary carcinoma of peritoneal origin is reported. Extraovarian peritoneal serous papillary carcinoma was characterized by ascites, malignant washings, and omental involvement with bulky infiltration and/or multiple tumor nodules. The symptoms caused by diffuse spreading of the neoplasm over the peritoneum are the most important manifestation for clinical diagnosis of malignant primary neoplasm of peritoneum, especially serous papillary carcinoma. This behaving tumor was at least partially responded to therapy. In this report, we describe a case of serous papillary carcinoma of peritoneum carring on proper management with brief review.
Ascites ; Carcinoma, Papillary* ; Diagnosis ; Female ; Humans ; Middle Aged ; Peritoneum*

BACKGROUND: In unilateral ureteral obstruction (UUO), the obstructed kidney is characterized by interstitial fibrosis and an increase in transforming growth factor (TGF)-beta1. Interstitial expression of TGF-beta1 is important in tublointerstitial fibrosis. The objectives of this study is to make new ribbon-type antisense oligodeoxynucleotides (ODN) for TGF-beta1 which are resistant to exonuclease and to examine the effcets of TGF-beta1 on reducing tubulointerstitial fibrosis of the kidney. METHODS: We introduced a new ribbon-type antisense ODN for TGF-beta1 in rats using the UUO model to block interstitial fibrosis by tail vein injection. A combination of one antisense sequences for TGF-beta1 was adopted to construct a large antisense molecule with a loop and stem. Artificial viral envelope (AVE)-type hemagglutinating virus of Japan (HVJ)-liposomes were used as a vector system for the delivery of antisense ODN. RESULTS: The levels of TGF-beta1 mRNA was decreased more in the cultured mesangial cells treated with ribbon-type antisense ODN than in that of a linear-type antisense ODN for TGF-beta1. TGF-beta1 mRNA was increased markedly in the interstitium of untreated obstructed kidneys. Northem analysis revealed that the levels of TGF-beta1 mRNA were decreased in the obstructed kidneys treated with antisense ODN. The fibrosis of the obstructed kidneys treated with ribbon-type antisense ODN was dramatically less than that of the untreated group. CONCLUSIONS: These results demonstrate that the introduction of new ribbon-type antisense ODN for TGF-beta1 may be a potential therapeutic maneuver for preventing interstitial fibrosis.
Animals ; Fibrosis ; Kidney ; Mesangial Cells ; Oligodeoxyribonucleotides* ; Rats ; RNA, Messenger ; Sendai virus ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; Ureter* ; Ureteral Obstruction* ; Veins

OBJECTIVE: We wanted to evaluate the feasibility and efficacy of using a dexamethasone (DM) -eluting nitinol stent to inhibit the pseudointimal hyperplasia following stent placement in the transjugular intrahepatic portosystemic shunt tract (TIPS) of a swine. MATERIALS AND METHODS: Fifteen stents were constructed using 0.15 mm-thick nitinol wire; they were 60 mm in length and 10 mm in diameter. The metallic stents were then classified into three types; type 1 and 2 was coated with the mixture of 12% and 20%, respectively, of DM solution and polyurethane (PU), while type 3 was a bare stent that was used for control study. In fifteen swine, each type of stent was implanted in the TIPS tract of 5 swine, and each animal was sacrificed 2 weeks after TIPS creation. The proliferation of the pseudointima was evaluated both on follow-up portogram and pathologic examination. RESULTS: One TIPS case, using the type 1 stent, and two TIPS cases, using the type 2 stent, maintained their luminal patency while the others were all occluded. On the histopathologic analysis, the mean of the maximum pseudointimal hyperplasia was expressed as the percentage of the stent radius that was patent, and these values were 51.2%, 50% and 76% for the type 1, 2, and 3 stents, respectively. CONCLUSION: The DM-eluting stent showed a tendency to reduce the development of pseudointimal hyperplasia in the TIPS tract of a swine model with induced-portal hypertension.
Swine ; *Stents ; *Portasystemic Shunt, Transjugular Intrahepatic ; Hyperplasia ; Dexamethasone/*administration & dosage ; Animals ; Alloys

PURPOSE: The increased use of antibiotics may be the main factor responsible for the development and spread of bacterial resistance. This study demonstrated the relation between quinolone use and the rate of isolating ciprofloxacin-resistant(CIPRO-R) Escherichia coli(E.coli) in patients with urinary tract infection(UTI). MATERIALS AND METHODS: From 2001 to 2006, we determined antimicrobial use for 2,803 in terms of the defined daily dose(DDD) and the antimicrobial use density(AUD), and we surveyed the isolation rates of CIPRO-R E.coli in UTIs in both inpatients and outpatients. We also analyzed the correlation between the number of prescriptions and the resistance rates. RESULTS: Of the 637(22.7%) CIPRO-R E.coli isolates, 297(46.6%) were from inpatients and 340(53.4%) were from outpatients. There was a statistically significant correlation between the rate of isolating CIPRO-R E.coli and the amount of quinolone use for the inpatients(r=0.815, p<0.05) as well as the outpatients(r=0.804, p<0.05). A logistic regression analysis identified previous quinolone use as the independent risk factor(odd ratio: 2.604 [95% confidence interval(CI): 1.639-4.137]) for CIPRO-R E.coli in inpatients. Also, these CIPRO-R E.coli showed low sensitivity to ampicillin and trimethoprim/sufamethoxazole(TMP/SMX) in the inpatients(10.4%, 27.3%) and outpatients(5.1%, 27.1%), respectively. CONCLUSIONS: Our study shows a significant correlation between ciprofloxacin resistance and quinolone use, and previous quinolone use seems to be the risk factor for CIPRO-R E.coli bacteriuria. It is necessary to keep antimictrobial therapy under constant surveillance for the prevention of CIPRO-R E.coli.
Ampicillin ; Anti-Bacterial Agents ; Bacteriuria ; Ciprofloxacin ; Escherichia ; Escherichia coli ; Humans ; Inpatients ; Logistic Models ; Outpatients ; Prescriptions ; Quinolones ; Risk Factors ; Urinary Tract ; Urinary Tract Infections

PURPOSE: Eperisone is an oral muscle relaxant used in musculoskeletal disorders causing muscle spasm and pain. For more effective pain control, eperisone is usually prescribed together with nonsteroidal anti-inflammatory drugs (NSAIDs). As such, eperisone may have been overlooked as the cause of anaphylaxis compared with NSAIDs. This study aimed to analyze the adverse drug reaction (ADR) reported in Korea and suggest an appropriate diagnostic approach for eperisone-induced anaphylaxis. METHODS: We reviewed eperisone-related pharmacovigilance data (Korea Institute of Drug Safety-Korea Adverse Event Reporting System [KIDS-KAERS]) reported in Korea from 2010 to 2015. ADRs with causal relationship were selected. Clinical manifestations, severity, outcomes, and re-exposure information were analyzed. For further investigation, 7-year ADR data reported in a single center were also reviewed. Oral provocation test (OPT), skin prick test (SPT) and basophil activation test (BAT) were performed in this center. RESULTS: During the study period, 207 patients had adverse reactions to eperisone. The most common ADRs were cutaneous hypersensitive reactions (30.4%) such as urticaria, itchiness or angioedema. Fifth common reported ADR was anaphylaxis. There were 35 patients with anaphylaxis, comprising 16.9% of the eperisone-related ADRs. In the single center study, there were 11 patients with eperisone-induced anaphylaxis. All the patients underwent OPT and all the provoked patients showed a positive reaction. Four of the 11 patients with anaphylaxis also underwent SPT and BAT, which were all negative. CONCLUSIONS: Incidence of eperisone-induced anaphylaxis calculated from the KIDS-KAERS database was 0.001%. Eperisone can cause hypersensitive reactions, including anaphylaxis, possibly by inducing non-immunoglobulin E-mediated immediate hypersensitivity.
Anaphylaxis ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; Basophils ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Incidence ; Korea ; Pharmacovigilance ; Skin ; Spasm ; Urticaria

BACKGROUND AND OBJECTIVES: This study was designed to investigate whether the serum concentration of the carboxy-terminal propeptide of procollagen type I PIP, a marker of myocardial fibrosis, was related to the change of the ventricular filling dynamics in patients with early type 2 diabetes mellitus (DM). SUBJECTS AND METHODS: Echocardiography was performed in 28 patients with type 2 DM and 32 age-matched healthy controls, ranging from 31-69 years of age, with normal left ventricular (LV) systolic function and ECG at rest. Subjects with diabetic complications, including microalbuminuria, nephropathy (Cr>1.3 mg/dL), severe obesity (BMI> or =30 kg/m2), LV hypertrophy (LV septal thickness and/or posterior wall thickness 12 mm on M-mode) and hypertension, were excluded. The serum concentrations of PIP and Transforming growth factor TGF-beta1 were measured by enzyme immunoassay methods. RESULTS: The type 2 DM group had lower mitral (Type 2 DM vs. Control: 0.88+/-0.28 vs. 1.17+/-0.34, p<0.01) and tricuspid E/A ratios (1.15+/-0.25 vs. 1.30+/-0.25, p=0.01) than the control group. The level of serum PIP was higher (p<0.05) in patients with type 2 DM than in the control group (131.1+/-45.6 vs. 109.3+/-32.5). The difference in the duration between transmitral forward (A) and pulmonary venous retrograde (Ar) waves (A-Ar) was considered an estimate of a passive diastolic function. A-Ar was inversely related with the serum PIP level in type 2 diabetes (r=-0.43, p=0.03). CONCLUSION: These results show a relationship between the LV diastolic function and the serum concentration of PIP in early type 2 DM. These findings suggest that the determination of the serum level of PIP is a useful method for the screening and early diagnosis of myocardial fibrosis associated with DM.
Collagen Type I ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diastole ; Early Diagnosis ; Echocardiography ; Electrocardiography ; Fibrosis* ; Humans ; Hypertension ; Hypertrophy ; Immunoenzyme Techniques ; Mass Screening ; Obesity, Morbid ; Procollagen ; Transforming Growth Factor beta1 ; Transforming Growth Factors

OBJECTIVE: The purpose of this study was to analyze the inclination, pertinence and influential factor in emergent cesarean section according to the assortment and analysis of the indication of emergent cesarean section. METHODS: The retrospective study was performed with the review of 360 emergent cesarean section cases from January 2003 to December 2003. RESULTS: The indication of cesarean section was followed by the order of progress failure (47.5%), previous cesarean section (19.2%), and fetal distress (15.8%). The improper operation of emergent cesarean section was done in fetal distress (28.1%), progress failure (8.6%), and induction failure (16.7%). The absence of acceleration with prolonged bradycardia was the most common (50.0%) type of fetal distress. The emergent cesarean section were done more commonly on Tuesday and Friday during weekdays and it was the peak time in a whole day of cesarean section from 11 o'clock to 12 o'clock and 16 o'clock to 17 o'clock. CONCLUSION: It was proved that twenty six (7.2%) cases of emergent cesarean section were done improperly. Now, work through the non-medical factors are considered more important to reduce improper section rate.
Acceleration ; Bradycardia ; Cesarean Section* ; Female ; Fetal Distress ; Pregnancy ; Retrospective Studies

OBJECTIVES: The purpose of this study is to evaluate and compare the maternal and neonatal complications of the overt diabetes with that of gestational diabetes. METHOD : The medical records of 65 pregnant patients complicated by diabetes mellitus at Eulji medical center from January, 2001 to December, 2002 were reviewed retrospectively. Thirteen patients of them were diagnosed as a overt diabetes and the others were diagnosed as a gestational diabetes. RESULTS: Maternal complications were that preeclampsia in 15.4% and preterm labor in 15.4% in overt diabetes patients and preeclampsia in 9.6%, fourth degree laceration in 1.9%, preterm labor in 3.8%, placenta abruption in 1.9%, cardiomyopathy in 1.9% and polyhydroamnios in 1.9% in gestational diabetes patients. Neonatal complications were that hypoglycemia in 38.5% and respiratory distress syndrome in 15.4% in overt diabetes patients and hypoglycemia in 25%, hyperbilirubinemia in 9.6% and shoulder dystocia in 1.9% in gestational diabetes patients. There were no statistic differences in maternal and neonatal complications in two groups when management had done. And in gestational diabetes group, maternal and neonatal complications were significantly higher in no management group than management group regardless of management types. CONCLUSION: If early detection and management were done in overt and gestational diabetes, there were no difference in maternal and neonatal complications. Regardless of types of diabetes, early detection and management were important.
Cardiomyopathies ; Diabetes Mellitus ; Diabetes, Gestational* ; Dystocia ; Female ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Lacerations ; Medical Records ; Obstetric Labor, Premature ; Placenta ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Shoulder