OBJECTIVE: To evaluated whether clusterin over-expression is significantly correlated with paclitaxel resistance in ovarian cancer cell lines. METHODS: Clusterin was validated by performing expression profiling analysis and subsequently, the correlation between clusterin mRNA expression levels and the IC50 of paclitaxel was tested. Transfection of clusterin was performed on SKOV3, which expressed paclitaxel-sensitivity and low level of clusterin, and transfection of clusterin siRNA on PEOH, which expressed paclitaxel-resistance and high level of clusterin, to evaluate their effect on chemo-sensitivity, apoptosis, and cell cycle by XTT assay, cell death ELISA, and flow cytometry, respectively. RESULTS: Clusterin mRNA and protein expression levels were significantly correlated with paclitaxel resistance (P<0.001). Transfection of cluterin on SKOV3 significantly decreased apoptosis and increased paclitaxel resistance. And transfection of clusterin siRNA on PEOH significantly increased paclitaxel-sensitivity (P<0.05), and shifted cells from S to G2/M phase of the cell cycle after paclitaxel treatment. CONCLUSION: These findings suggested that clusterin overexpression confers paclitaxel-resistance by the modulation of the apoptotic pathway and cell cycle progression in ovarian cancer cells.
Apoptosis ; Cell Cycle ; Cell Death ; Cell Line ; Clusterin* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Inhibitory Concentration 50 ; Ovarian Neoplasms* ; Paclitaxel* ; RNA, Messenger ; RNA, Small Interfering ; Transfection

A 39-year-old man, his 35-year-old wife, and their 13-year-old daughter were found dead in their home. The man and his daughter were found lying in her bedroom, with his head wrapped in a plastic bag connected to four helium gas cylinders by green polypropylene tubes. Fragments of the burnt ignition briquette were found in the bucket located at her feet. His wife was found in a decomposed state lying on her right side in her bedroom. Autopsy findings for the man were unremarkable except for cherry pink lividity; the blood carboxyhemoglobin concentration was 73%. Autopsy findings were unremarkable for the woman as well, except for a few petechial hemorrhages and conjunctival congestion. The daughter showed no definite abnormalities; however, her blood and lung contained helium gas. The deceased man's suicide note, evidence gathered at the scene, and postmortem examination revealed that this was a case of dyadic death.
Adolescent ; Adult ; Asphyxia ; Autopsy* ; Carboxyhemoglobin ; Deception ; Estrogens, Conjugated (USP) ; Female ; Foot ; Head ; Helium* ; Hemorrhage ; Humans ; Lung ; Nuclear Family ; Plastics ; Polypropylenes ; Prunus ; Spouses ; Suicide

Dysphagia is a disorder of the swallowing mechanism and presents a major problem in the rehabilitation of stroke patients. In-the present study, computerized laryngeal analyzer (CLA) was used for noninvasive assessment of the pharyngeal phase of the swallowing mechanism. Laryngeal elevation was measured with pressor sensor placed on the skin over the thyroid cartilage. In the study. CLA was applied at each posture of neck flexion, neutral, and extension in stroke group and control group. Significant differences were found in each of the these parameters measured in control group and stroke group. The quantitative measurements may aid the physician in choosing the appropriate therapy during the course of recovery. The onset latency of swallowing was delayed in stroke group than control group at all posture of neck(p<0.05). The pharyngeal transit time (PTT) was longer at extension than flexion and neutral posture of neck in stroke group(p<0.05). The PTT was longer in stroke group than control group at all posture of neck, but not significant(p>0.05). The amplitude of swallowing was decreased in stroke group at extension and neutral posture of neck compared to those of control group (p<0.05), but there was no significant difference between stroke group and control group in neck flexion (p>0.05).
Deglutition Disorders ; Deglutition* ; Humans ; Neck* ; Posture* ; Rehabilitation ; Skin ; Stroke* ; Thyroid Cartilage

Recently, worldwide dietary reference intakes have been considered an important guideline for public health. Some governments and the World Health Organization (WHO) provide guidelines concerning dietary intake. Although an ingredient may have a history of use as a culinary material, changes in the environment over time suggest that the acceptable maximum intake each of food/culinary material should be regularly evaluated. Arctium lappa L. has been used as a culinary material for many centuries in Korea and Japan and some recent studies have reported related therapeutic effects. However, there are no reports on the safety of repeated oral administration. In this study, we evaluated the safety of a 8-weeks repeated oral intake of A. lappa. We concluded that treatment with <250 mg/kg A. lappa, which was within the safety range, resulted in body weight decrease and blood glucose suppression.
Administration, Oral* ; Arctium* ; Blood Glucose ; Body Weight ; Japan ; Korea ; Public Health ; Recommended Dietary Allowances ; Therapeutic Uses ; World Health Organization

Actinomycosis is an oppoturnistic infection of actinomyces, which are relatively avirulent endogenous oral commensals. After trauma or infection, they breach the normally protective mucosal barriers to invade adjacent soft tissue structures. Lesions routinely contain other bacteria, the normal resident flora at the site of primary infection, which act synergistically with actinomyces species to provoke this unique infection, which range from an acute suppurative process to a chronic fibrotic process. According to epidemic studies about pelvic actinomycosis, it should be significantly related to IUD(intrauterine device). It is accounted that IUD cause chronic intrauterine infection, tissue injury and act as nucleus for parasitic infestation. Here we present a case of pelvic actinomycosis related to IUD with brief review of the concerned literature.
Actinomyces ; Actinomycosis* ; Bacteria

PURPOSE: Advanced gastric cancer confined to the muscularis propria is considered to be an intermediate-stage carcinoma, between early and more advanced cancer from both the pathological and clinical viewpoints of the primary tumor stage. Although many prognostic factors for early gastric cancer and advanced gastric cancer have been identified, there are few reports concerning prognostic factors for gastric cancer invading the muscularis propria, and the characteristics of recurrence are not completley understood. METHODS: One hundred and fifty-six patients who had undergone curative resection for gastric cancer invading the muscularis propria from 1992 to 2000 were retrospectively reviewed. The risk factors that determined the recurrence were investigated by univariate and multivariate analysis. RESULTS: Disease recurred in 31 patient (19.9%) after a median interval of 17.2 months. Based on our univariate analysis, the recurrence was associated with lymph node metastasis, tumor size and histologic type. Multivariate analysis showed that independent risk factor for the recurrence was only lymph node metastasis. Recurrent disease patterns included hematogenous (38.7%), peritoneal (16.1%) and locoregional (25.8%). CONCLUSION: Lymph node metastasis is an important risk factor of the recurrence after curative resection for gastric cancer invading the muscularis propria. Patients with lymphatic metastasis, particularly with 4 or more nodal imvolvements, should undergo postoperative adjuvant therapy.
Humans ; Lymph Nodes ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Stomach Neoplasms

BACKGROUND: TNF-alpha is related to the generation of lung fibrosis in patients with UIP. The precise mechanism leading to lung fibrosis by TNF-alpha is unknown. However, the activation of a transcription factor like AP-1(down stream of c-jun N-terminal kinase, JNK) by TNF-alpha may be related to the induction of fibrogenic cytokines like PDGF or IGF-I. Furthermore, JNK was reported to be activated in the radiation-in-duced lung fibrosis model. This study examined JNK activity in patients with UIP. METHODS: The expression of phosphorous JNK(p-JNK), macrophage/moncoyte specific markers, CD68, and cytokeratin was evaluated by immunohistochemical (IHC) staining of lung tissues from patients with UIP and lung cancer. An in vitro kinase assay was performed with alveolar macrophages obtained by a bronchollung cancer. An in vitro kinase assay was performed with alvolar macrophages obrtained by a bronchol avleolar lavage from patients with UIP and healthy persons as the control. RESULTS: The IHC stain showed that p-JNK is expressed in the almost all of the alveolar macrophages and smooth muscle cells in patients with UIP. In case of the normal areas of the lung from patients with lung cancer, the alveolar macrophages showed little p-JNK expression. Interestingly, increased JNK activity was not found in the in vitro kinase assay of the alveolar macrophages obtained from both patients with UIP and healthy persons as the control. Furthermore, 10 ng/ml of TNF-alpha failed to increase the JNK activity of the alveolar macrophages in both patients with UIP and healthy people. CONCLUSION: The JNK was activated constitutionally in patients with UIP. However, the role of JNK in the pathogenesis of lung fibrosis needs to be clarified.
Constitution and Bylaws ; Cytokines ; Fibrosis ; Humans ; Insulin-Like Growth Factor I ; JNK Mitogen-Activated Protein Kinases* ; Keratins ; Lung ; Lung Neoplasms ; Macrophages ; Macrophages, Alveolar ; Myocytes, Smooth Muscle ; Phosphotransferases ; Rivers ; Therapeutic Irrigation ; Transcription Factors ; Tumor Necrosis Factor-alpha

PURPOSE: Multiple early gastric cancers were found in 6.9~11.7% of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. MATENRIALS AND METHODS: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of 1993~1998 at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. RESULTS: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients (4.5%), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 (53.8%) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, 46.1%). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 (58.3%) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 (30.8%) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient (8.3%). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. CONCLUSION: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.
Adenocarcinoma ; Female ; Humans ; Korea ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Stomach ; Stomach Neoplasms*

BACKGROUND: The prevalence and prognostic value of overt disseminated intravascular coagulation (DIC) in patients with septic shock presenting to emergency departments (EDs) is poorly understood, particularly following the release of a new definition of septic shock. The purpose of this study was to investigate the prevalence and prognostic value of DIC in septic shock. METHODS: We performed retrospective review of 391 consecutive patients with septic shock admitting to the ED of tertiary care, university-affiliated hospital during a 16-month. Septic shock was defined as fluid-unresponsive hypotension requiring vasopressor to maintain a mean arterial pressure of 65 mmHg or greater, and serum lactate level ≥ 2 mmol/L. Overt DIC was defined as an International Society on Thrombosis and Hemostasis (ISTH) score ≥ 5 points. The primary endpoint was 28-day mortality. RESULTS: Of 391 patients with septic shock, 290 were included in the present study. The mean age was 65.6 years, the 28-day mortality rate was 26.9%, and the prevalence of overt DIC was 17.6% (n = 51) according to the ISTH score. The median DIC score was higher in non-survivors than in survivors (5.0 vs. 2.0, p = 0.001). Significant higher risk of mortality was observed in overt DIC patients compared to those without (28.2% vs. 13.7%, p = 0.005). Multivariable logistic regression analysis identified DIC to be independently associated with 28-day mortality (odds ratio, 2.689 [95% confidence interval, 1.390-5.201]). CONCLUSIONS: Using the ISTH criteria of DIC, overt DIC in septic shock was found to be common among patients admitting to the ED and to be associated with higher mortality when it is accompanied with septic shock. Efforts are required to identify presence of overt DIC during the initial treatment of septic shock in patients presenting the the ED.
Arterial Pressure ; Consensus* ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Emergencies* ; Emergency Service, Hospital* ; Hemostasis ; Humans ; Hypotension ; Lactic Acid ; Logistic Models ; Mortality ; Prevalence* ; Retrospective Studies ; Shock, Septic* ; Survivors ; Tertiary Healthcare ; Thrombosis

PURPOSE: The prognosis for Borrmann type 4 gastric cancer is dismal although therapies for gastric cancer have been developed. We investigated the outcomes for Borrmann type 4 gastric cancers compared to those for other types of cancer. MATENRIALS AND METHODS: Between 1993 and 2000, 777 patients with advanced gastric cancer underwent surgical resection at the Department of Surgery, Korea University Hospital. The clinicopathologic features of 138 patients with Borrmann type 4 carcinomas of the stomach were retrospectively reviewed from the database of gastric cancer. The results were compared with those of 639 patients with other types of gastric carcinomas. RESULTS: Patients with Borrmann type 4 carcinomas tended to be younger and to have larger tumors. The location, the depth of invasion, lymph node metastasis, and distant metastasis were significantly different between the two groups. Patients with Borrmann type 4 carcinomas had a more advanced stage than patients with other types of carcinomas. The analysis of the treatment factors revealed that total gastrectomies were more frequent in the group with Borrmann type 4 carcinomas and that the curative resection rate of patients with Borrmann type 4 gastric carcinomas was lower than that of patients with other types of gastric carcinomas (P<0.001). The 5-year survival rate for Borrmann type 4 gastric cancer was 19.4% and that for other types was 52.9% (P=0.001). In curative cases, the 5-year survival rates were 32.8% for patients with Borrmann type 4 gastric carcinomas and 63.4% for other types of carcinomas (P=0.001). CONCLUSION: Borrmann type IV gastric cancer has more advanced features and a poorer prognosis than other types of gastric cancer. Improving the prognosis for patients with Borrmann type 4 gastric cancer requires early detection and a curative resection.
Gastrectomy ; Humans ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate