BACKGROUND: Infiltration of eosinophils and activated T cells into the airway is a characteristic feature of allergic inflammation such as asthma. IL-4 has been shown to mediate adhesion of eosinophils and T cells to endothelial cells by inducing VCAM-1 expression on endothelial surface. IL-13 shares a number of biologic properties with IL-4. OBJECTIVE: We aimed to investigate the effects of IL-13 on the adhesion of eosinophils to human umbilical vein endothelial cells (HUVEC) and on the expression of VCAM-1 in HUVEC. METHOD: HUVEC was incubated for 24h with IL-13 (10ng/ml), IL-4 (10ng/ml) and TNF-a (10ng/ml). Surface expression of VCAM-1 in HUVEC was detected using irnmuno-cytochemical stain and reverse transcription-polymearse chain reaction (RT-PCR), and the adhesion of eosinophils to HUVEC was quantitated using eosinophil peroxidase (EPO) assay. RESULTS: The VCAM-1 expression on IL-13-treated HUVEC increased more than in the expression on medium-treated HUVEC (p<0.05). The adhesion of eosinophil to IL-13- treated HUVEC also increased more than in the adhesion to medium-treated HUVEC (p<0.05). The VCAM-1 expression was synergistically induced by TNF-a and IL-13 (p<0.05). IL-13 induced VCAM-1 expression and adhesion of eosinophils to HUVEC, similar to IL-4. IL-13 also induced VCAM-1 mRNA expression, with greater expression than with medium and TNF-a(p<0.05). IL-13-induced surface VCAM-1 was associated with expression of mRNA transcripts and adhesion of eosinophils to HUVEC(r=0.89, r=0.93, p<0.05). CONCLUSION: These findings demonstrate that IL-13 stimulates HUVEC to express surface VCAM-1 and has a possible role in promoting VCAM-1/VLA-4 dependent accumulation of eosinophils during allergic and other inflammatory responses.
Asthma ; Endothelial Cells* ; Eosinophil Peroxidase ; Eosinophils* ; Human Umbilical Vein Endothelial Cells ; Inflammation ; Interleukin-13* ; Interleukin-4 ; RNA, Messenger ; T-Lymphocytes ; Vascular Cell Adhesion Molecule-1

BACKGROUND: The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during as asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. METHOD: A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age-and sex-matched subjects with stable asthma. RESULTS: The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma (233±175 pg/ml) than in the 48 subjects with stable asthma(169±74 pg/ml). A tread toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids (332±225 pg/ml) than in those who were not (214±159 pg/ml) and higher levels were found in those admitted to the hospital (275±212 pg/ml) than in those discharged after receiving only emergency treatment (190±115 pg/ml). The eotaxin levels inversely correlated with the FEV1 (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent (323±256 pg/ml) and severe persistent asthmatics (276±170 pg/ml) than in mild intermittent asthmatics (160±60 pg/ml). CONCLUSION: Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.
Asthma* ; Case-Control Studies ; Emergency Treatment ; Eosinophils ; Humans ; Plasma* ; Steroids

No abstract available.
Granulomatous Disease, Chronic* ; Trimethoprim-Sulfamethoxazole Combination

Lymphangioleiomyomatosis(LAM) is a rare disease of unknown etiology that occurs mainly in woman in her reproductive age. We recently experienced two cases of bilateral diffuse cystic lesion of the lung on chest X-ray and HRCT. The first case, a 26-year-old female, who had been diagnosed with tuberous sclerosis be the presence of clinical manifestation such as mental retardation, bilateral renal angiomyolipoma, adenoma sebaceum and generalized seizure, was admitted due to recently developed hemoptysis. Chest PA showed diffuse ground-glass opacity with radiolucent cystic lesions of various sizes on both lung fields. HRCT showed innumerable small cystic lesions with suspicious diffuse ground-glass opacity on both lung fields. The second case, a 30-year-old female was admitted due to dyspnea and spewing of blood-tinged sputum for 2 weeks, shortly after delivery. Chest PA showed diffuse reticular and ground-glass opacities on both lung field. HRCT showed multiple well-difined and relatively uniform size air cysts with a uniform wall thickness on entire both lung fields, with small amount of right pleural effusion. By thoracoscopic lung biopsy she was diagnosed with pulmonary lymphangioleiomyomatosis. We report these cases with a brief review of the literatures.
Adult ; Angiomyolipoma ; Biopsy ; Dyspnea ; Female ; Hemoptysis ; Humans ; Intellectual Disability ; Lung ; Lymphangioleiomyomatosis ; Pleural Effusion ; Rare Diseases ; Seizures ; Sputum ; Thorax ; Tuberous Sclerosis

BACKGROUND: The determinants of intubation and the response to therapy in COPD patients with hypercapnic respiratory failure were retrospectively reviewed. METHODS: This study involved a review of 132 episodes of hypercapnic respiratory failure(PaCO2≥50mmHg and pH≤7.35). The time frame for resolution or the time to intubation of patients who were admitted between 1996 and 1999 was analyzed. RESULTS: Out of 132 hypercapnic episodes, 49(37%) required intubation. A comparison was made with the 83 cases that responded to treatment. Patients requiring intubation had greater severity of illness, which included a higher APACHE II (Acute Physiology and Chronic Health Evaluation II) score (20±5 vs 14±4 ; p<0.01), a higher WBC, a higher serum BUM, and greater acidosis (pH, 7.23±0.11 vs 7.32±0.04 ; p<0.01). Those with the most severe acidosis(pH<7.20) had the highest intubation rate(87%) and shortest time to intubation (2±3 h). Conversely, those with an initial pH 7.31 to 7.35 were less likely to be intubated(20%), and had a longer time to intubation(97±121 h). The patients with a pH 7.21 to 7.25(4.1±2.9 day) required longer period of time to respond to medical treatment than patients with a pH of 7.31 to 7.35(2.2±3.1 day). Of those patients requiring intubation, half(55%) were intubated within 8 h of admission, and most (75%) within 24 h. Of those patients responding to treatment medical therapy, half(52%) recovered within 24 h and most (78%) recovered within 48 h. CONCLUSION: Respiratory acidosis at the initial presentation is associated with an increased likelihood of intubation. This shold assist in deciding help with the decision whether to treat patients medically, institute noninvasive ventilation, or proceed to intubation.
Acidosis ; Acidosis, Respiratory ; APACHE ; Humans ; Hydrogen-Ion Concentration ; Intubation* ; Noninvasive Ventilation ; Physiology ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Insufficiency* ; Retrospective Studies

Transplanting fetal kidney cells (FKCs) can regenerate kidney. This requires in vitro expansion in cell number to acquire enough cells for transplantation. However, FKCs may change their cellular characteristics during expansion and, thus, may not regenerate kidney tissue upon transplantation. We investigated how cell culture period affects cellular characteristics and in vivo regenerative potential of FKCs. As the passage number increased, cell growth rate and colony forming ability decreased while senescence and apoptosis increased. To examine in vivo regenerative potential, FKCs cultured through different numbers of passages were implanted into the parenchyma of kidneys of immunodeficient mice using fibrin gel for 4 wk. Histological analyses showed passage-dependent kidney tissue regeneration, and the regeneration was better when cells from lower number of passages were implanted. This result shows that in vitro culture of FKCs significantly affects the cell characteristics and in vivo tissue regenerative potential.
Animals ; Apoptosis/physiology ; Cell Aging/physiology ; Cell Culture Techniques ; Cell Proliferation ; Cells, Cultured ; Colony-Forming Units Assay ; Female ; Fetal Tissue Transplantation/methods/physiology ; Fetus/cytology/*physiology ; Kidney/embryology/*physiology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Rats ; Rats, Sprague-Dawley ; Regeneration/*physiology

A 60-year-old man with bilateral corneal opacity underwent cataract extraction surgery involving the use of a limbal relaxing incision in his left eye. He had lower lid ectropion and lagophthalmos in both eyes. Eleven days after the surgery, a slit-lamp examination revealed a neurotrophic corneal ulcer with a punch-out epithelial defect and rolled edges at the center of the pre-existing corneal opacity. The patient was treated with sodium hyaluronate, autologous serum, and oral doxycycline. Six weeks after the surgery an improvement in corneal sensation was observed and the neurotrophic corneal ulcer subsequently healed over the course of one year. In this report, we present a case of neurotrophic keratitis that occurred after performing cataract surgery concurrent with a limbal relaxing incision. As such, we suggest that limbal relaxing incisions should be performed cautiously in patients with causative risk factors for corneal hypesthesia.
Cataract Extraction/*adverse effects/*methods ; Corneal Diseases/etiology ; Corneal Ulcer/*etiology/*pathology/physiopathology ; Humans ; Hypesthesia/etiology ; Limbus Corneae/*surgery ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures/*adverse effects ; Phacoemulsification ; Wound Healing

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*

Renovascular hypertension secondary to renal artery vascular disease is the most common form of surgically correctable hypertension. The common causes of renovascular hypertension are atherosclerosis, fibromuscular dysplasia, and Takayasu arteritis. Takayasu arteritis is a chronic nonspecific arteritis of unkown cause that is relatively prevalant in young female subjects. It has been well known that the pathologic feature of the disease consist predominantly of occulsive changes in the aorta and the origin of its major branches. The most important pathogenetic mechanism of hypertension seems to be through renal artery stenosis. We have experimented three hypertensive patients with Takayasu arteritis experienced. Basic diagnosis was established by angiographic study. This article presents surgical treatment methods of Takayasu arteritis with renovascular hypertension and brief review of literatures.
Aorta ; Arteritis ; Atherosclerosis ; Diagnosis ; Female ; Fibromuscular Dysplasia ; Humans ; Hypertension ; Hypertension, Renovascular ; Renal Artery ; Renal Artery Obstruction ; Takayasu Arteritis ; Vascular Diseases

Immunoglobulin G4 (IgG4)-related kidney disease is a chronic immune-mediated fibro-inflammatory disorder characterized by multiple organ infiltration with IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis or tumefactive lesions. Previous studies have explored IgG4-related kidney disease, increasing our understanding of its clinical manifestations, and pathological and radiologic findings. However, IgG4-related kidney disease can be misdiagnosed since it mimics malignancies. We report a case of a 77-year-old Korean man diagnosed with IgG4-related kidney disease with membranous proliferative glomerulonephritis, presenting with a renal pelvic mass suspected of being malignant.