Autophagy is a life-sustaining process by which cytoplasmic constituents are segregated in double-lipid bilayer membrane vesicles and undergo degradation into lysosomes. In recent studies, the basal autophagy is an indispensable process mediating proper vascular function in the body. Moreover, autophagy activated by many stress-related stimuli in the arterial wall protects endothelial cells and smooth muscle cells against cell death and the progression of vascular disease including atherosclerosis. Autophagy is protective to atherosclerosis during early stage but becomes dysfunctional in advanced atherosclerotic lesions. Following this finding, the need is emphasized which pharmacological development with compounds that activate the protective effects of autophagy in the vascular disease. Autophagy stimulated by oral or vascular delivery of rapamycin or derivatives effectively suppressed the atherosclerotic plaque growth and plaque destabilization. In this review, the recent finding is summarized on the role of autophagy in atherosclerosis and find out whether the activation or rescue of autophagy could provide a breakthrough in the treatment of atherosclerosis.
Atherosclerosis* ; Autophagy* ; Cell Death ; Cytoplasm ; Endothelial Cells ; Lysosomes ; Membranes ; Myocytes, Smooth Muscle ; Negotiating ; Plaque, Atherosclerotic ; Sirolimus ; Vascular Diseases

BACKGROUND: Standardized management and surveillance at a national level is essential to maintain blood product safety. Officials of the Korean Division of Human Blood Safety Surveillance, Korea Centers for Disease Control and Prevention, and Korean laboratory transfusion medicine specialists, currently participate as inspectors in the Korean National Blood Inspection Program for Blood Establishments. However, lack of definitive guidelines and absence of standardized inspector training programs compromise the goal of objective and consistent safety management results. In this study, we propose establishment of written inspection guidelines and a clearly documented accreditation training program. METHODS: Inspector training programs in the US and EU were reviewed online and the results of the Korean National Blood Inspection in our country performed during last 4 years were analyzed. RESULTS: We suggested inspection guidelines for every question of inspection checklists. Also, for the questions similar to those of Laboratory Accreditation Program of the Korean Society for Laboratory Medicine (KSLM), guidelines were proposed as 'Results of Laboratory Accreditation Program of the KSLM could be concerned if inspected laboratory obtained 2 year accreditation lately'. We suggest an 18hr-basic training program composed of lectures, e-learning and a visit to a blood center, as well as 12hr-continuing courses, should be established. CONCLUSION: To establish the Blood Inspection Program in a more systematic manner, thorough management and training of inspectors are essential. We expect the guidelines and training program for inspectors, suggested in our study, will be the cornerstone for creating a more professional quality management system and further ensure the safety of the national blood management system.
Accreditation ; Blood Safety ; Centers for Disease Control and Prevention (U.S.) ; Checklist ; Dietary Sucrose ; Humans ; Korea ; Lectures ; Safety Management ; Specialization

BACKGROUND: Five-day regimen of FP (5-fluorouracil, cis-platinum) combination chemotherapy for advanced gastric cancer is one of the popular regimens with approximate 40% of response rate in many series of clinical trials. This study was designed to assess the therapeutic effect and toxicity of three days regimen of FP combination chemotherapy instead of five days regimen for disseminated or recurrent gastric cancer. METHODS: From July 1996 through July 2000, 32 patients with inoperable or recurrent gastric cancer were enrolled in the study. The regimen consisted of continuous 12-hour infusion of 5-FU 1000 mg/m2/day plus bolus infusion of cisplatin 25 mg/m2/day for 3 days. The treatment was repeated every 3 weeks. RESULTS: Thirty patients were evaluable for response with a median follow up of 27 months. No one entered complete remission. There were 9 partial responses with the response rate of 30%. Median overall survival duration was 9.1 months. It was longer in responders than that in non-responders .(20.5 months vs 8.0 months, p<0.01) Toxicity was acceptable with no treatment related mortality. Toxicities in grade 3 or more included neutropenia in 5% and vomiting in 10% throughout a total of 160 treatment courses with no febrile episode. CONCLUSION : These results revealed that the toxicity of 3 day regimen of 5-FU and cisplatin is acceptable and the efficacy comparable to that of 5 day regimen.
Cisplatin* ; Drug Therapy, Combination* ; Fluorouracil* ; Follow-Up Studies ; Humans ; Mortality ; Neutropenia ; Stomach Neoplasms* ; Vomiting

BACKGROUNDS: Peripheral blood stem cells (PBSC) are increasingly used because of ease of collection and rapid kinetics of recovery relative to bone marrow transplantation (BMT). Here we summarize laboratory and clinical experiences of 671 PBSC harvests performed at a single institution. METHODS: PBSC harvests were performed mainly with Fenwal CS3000 plus blood cell separator. 126 cancer patients and 12 allogeneic BMT donors (54 children, 84 adults) were enrolled in this study. Total WBC and mononuclear cells (MNC) were analyzed in peripheral blood before procedure, and total WBC, MNC and CD34+ cell count on PBSC product. Correlation between dose of CD34+ cells and hematologic recovery was evaluated by Wilcoxon rank sum test and Pearson correlation analysis. RESLUTS: A mean of 4.8 leukapheresis was performed and 9,155 mL blood was processed. A mean volume of PBSC product was 66 mL and MNC purity of that was 84%. An average of 3.0 +/- 3.3x108 WBC/kg, 2.4 +/- 2.6x108 MNC/kg, and 2.7 +/- 5.4x106 CD34+ cells/kg was collected in each procedure. A goal of 1x108/kg MNCs was reached in 98.4% (127/129) of the patients and more than 1x106/kg CD34+ cells were collected in 91.8% (90/98). Various complications of PBSC harvests were observed but the incidence of serious adverse reaction was low. Median times to an absolute neutrophil count over 500/uL were 11 (7-34) and 11 (8-29) days respectively, in adult and children, and those to a sustained platelet count over 50,000/uL were 18.5 (9-118) and 36 (16-85) days, respectively. CONCLUSION: We analyzed yield, adverse reaction and hematologic recovery of PBSC harvests and this can serve basic data for the PBSC procedure.
Adult ; Blood Cells ; Bone Marrow Transplantation ; Cell Count ; Child ; Humans ; Incidence ; Kinetics ; Leukapheresis ; Neutrophils ; Platelet Count ; Stem Cells* ; Tissue Donors

BACKGROUND: Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. METHODS: This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’ RESULTS: The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. CONCLUSION: Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.
Adolescent* ; Cross-Sectional Studies ; Female ; Health Behavior ; Humans ; Korea* ; Problem Behavior ; Risk-Taking* ; Smoke* ; Smoking* ; Weight Loss

BACKGROUND: Influenza causes morbidity and mortality, resulting in the medical and socioeconomic costs. We aimed to analyse whether socioeconomic and medical factors may affect influenza vaccination status divided into 2 groups; one aged 19 to 64 years old and the other aged 65 or over who are eligible for free vaccination. METHODS: The study included 1,412 individuals aged 19 and over who responded to influenza vaccination survey, based on 2013 National Health and Nutrition Examination Survey. Related factors were categorized into socioeconomic factors and medical factors. Univariate analyses were conducted to examine the correlations between vaccination rate and each variables. Multivariate analysis was obtained after adjusting variables which were statistcally significant. RESULTS: Influenza vaccination rate was significantly different in the population aged 19 to 64 (24.9%) and the population aged 65 or over (80.5%). In the former population, high vaccination rate was associated with healthcare usage (odds ratio [OR]=1.37, 95% confidence interval [CI]=1.03-1.83), underlying chronic diseases (OR=2.21, 95% CI=1.43-3.40), and public assistance recipient households (OR=2.21, 95% CI=1.03-4.78), while low vaccination rate was correlated with no use of medical check up (OR=0.70, 95% CI=0.52-0.94) and heavy alcoholics (OR=0.41, 95% CI=0.24-0.70). In the latter population aged 65 or over, high vaccination rate was associated with healthcare usage (OR=1.82, 95% CI=1.28-2.59), and underlying malignancies (OR=4.79, 95% CI=1.07-21.54), whereas low vaccination rate was associated with public assistance recipient households (OR=0.33, 95% CI=0.14-0.76), and no use of medical check up (OR=0.37, 95% CI=0.19-0.73). CONCLUSIONS: In the population below 65 years old, vaccination rate would be expected to rise by the recommendation of medical care providers and expanding the coverage of free vaccination. In elderly, individualized care for those who have less access to medical care and high susceptibility is highly recommended.
Adult* ; Aged ; Alcoholics ; Chronic Disease ; Delivery of Health Care ; Family Characteristics ; Humans ; Influenza Vaccines ; Influenza, Human* ; Mortality ; Multivariate Analysis ; Nutrition Surveys ; Public Assistance ; Socioeconomic Factors ; Vaccination*

In this study, we isolated scopoletin from Cirsium setidens Nakai (Compositae) and tested its effects on melanogenesis. Scopoletin was not toxic to cells at concentrations less than 50 microM and increased melanin synthesis in a dose-dependent manner. As melanin synthesis increased, scopoletin stimulated the total tyrosinase activity, the rate-limiting enzyme of melanogenesis. In a cell-free system, however, scopoletin did not increase tyrosinase activity, indicating that scopoletin is not a direct activator of tyrosinase. Furthermore, Western blot analysis showed that scopoletin stimulated the production of microphthalmia-associated transcription factor (MITF) and tyrosinase expression via cAMP response element-binding protein (CREB) phosphorylation in a dose-dependent manner. Based on these results, preclinical and clinical studies are needed to assess the use of scopoletin for the treatment of vitiligo.
Blotting, Western ; Cell-Free System ; Cirsium* ; Cyclic AMP Response Element-Binding Protein ; Melanins* ; Microphthalmia-Associated Transcription Factor ; Monophenol Monooxygenase ; Phosphorylation* ; Scopoletin* ; Vitiligo

BACKGROUND: Gefitinib targets the epidermal growth factor receptor r(EGFR), and Gefitinib has antitumor activity in patient with non-small cell lung cancer (NSCLC). However, only 10 to 20 percent of patients show a clinical response to this drug, and the molecular mechanisms underlying patient sensitivity to gefitinib are unknown. PTEN (Phosphatase and tensin homolog deleted on chromosome Ten) plays a role for the modulation of the phosphat?idylinositol 3-kinase pathway (PI3K), which is involved in cell proliferation and survival, so that it can inhibit cell cycle progression and induce G1 arrest. Therefore, we analyzed the relationship between PTEN expression and gefitinib's responsiveness in patients having advanced non small cell lung cancer that had progressed after previous chemotherapy. METHODS: The expression of PTEN was studied by immunohistochemistry in paraffin-embedded tumor blocks that were obtained from 22 patients who had been treated with gefitinib from JAN, 2001 to AUG. 2004. For the evaluation of the relationships between the PTEN expression, the clinical stage and the basal characteristics, those cases that showed the respective antigen expression in >50% of the tumor cells were considered positive. RESULTS: The positive rate of PTEN staining was 55% of the total of 22 patients. There was a significant relationship between the increased expression of PTEN and the response group (p=0.039). However, there was no significant relationship between the expression of PTEN and other clinicopathologic characteristics. CONCLUSION: The expression of PTEN in patients with advanced non small cell lung cancer that has progressed after previous chemotherapy may play a role in gefitinib's responsiveness.
Carcinoma, Non-Small-Cell Lung* ; Cell Cycle ; Cell Proliferation ; Drug Therapy ; Humans ; Immunohistochemistry ; Receptor, Epidermal Growth Factor ; Small Cell Lung Carcinoma

BACKGROUND/AIMS: Chemotherapy combined with radiation therapy is the standard treatment for limited stage small cell lung cancer (LS-SCLC). Although numerous studies indicate that the overall duration of chemoradiotherapy is the most relevant predictor of outcome, the optimal chemotherapy and radiation schedule for LS-SCLC remains controversial. Therefore we analyzed the time from the start of any treatment until the end of radiotherapy (SER) in patients with LS-SCLC. METHODS: We retrospectively analyzed 29 patients diagnosed histologically with LS-SCLC and divided them into two groups: a short SER group (< 60 days) and a long SER (> 60 days) group. Patients were treated with irinotecan-based chemotherapy and thoracic radiotherapy. RESULTS: Sixteen patients were in the short SER group and 13 patients were in the long SER group. Short SER significantly prolonged survival rate (p = 0.03) compared with that of long SER. However, no significant differences in side effects were observed. CONCLUSIONS: Short SER should be considered to improve the outcome of concurrent chemoradiotherapy for LS-SCLC.
Aged ; *Chemoradiotherapy ; Chi-Square Distribution ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms/mortality/pathology/*therapy ; Male ; Middle Aged ; Neoplasm Staging ; Odds Ratio ; Proportional Hazards Models ; Retrospective Studies ; Small Cell Lung Carcinoma/mortality/pathology/*surgery ; Time Factors ; Treatment Outcome