PURPOSE: This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. MATERIALS AND METHODS: Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. RESULTS: SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 patients with renal arterial variation showed focally decreased radioactivity and SPECT helped guide further studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. CONCLUSION: Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings.
Allografts ; Artifacts ; Humans ; Kidney* ; Necrosis ; Radioactivity ; Tomography, Emission-Computed, Single-Photon* ; Ureter

Smoking is one of the most harmful causes of disease. Many previous researches have shown that cigarette smoking leads to cardiovascular, respiratory, oncologic, and cerebrovascular diseases. In addition to such adverse effects, the literature indicates that cigarette smoking can worsen sleep quality and induce sleep disorders. This review focuses on the relationship between smoking/nicotine and sleep and sleep disorders of insomnia, obstructive sleep apnea, and restless legs syndrome. Because smoking is a behavioral pattern that can be changed, it is important to quit smoking to improve overall health and sleep.
Cerebrovascular Disorders ; Nicotine ; Restless Legs Syndrome ; Sleep Apnea, Obstructive ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders ; Smoke ; Smoking ; Tobacco Products

PURPOSE: We evaluated whether aminoguanidine could inhibit VEGF mRNA expression in the retinal pigment epithelial cells cultured at various glucose concentrations. METHODS: Human retinal pigment epithelial cells were cultured in the culture media containing 5.5 mM, or 11 mM, or 16 mM glucose for 5 days, or 7 days, or 14 days respectively. To evaluate an inhibitory effect of aminoguanidine on VEGF mRNA expression, 1 micro M, or 3 micro M, or 10 micro M aminoguanidine was added in the culture media. The VEGF mRNA expression was assayed by northern blot analysis. RESULTS: The VEGF mRNA expression of the cultured retinal pigment epithelial cells increased proportionally with media glucose concentration in culture media. At each glucose concentration of the media, VEGF mRNA expression increased with a prolongation of incubation period. An aminoguanidine inhibited the expression of VEGF mRNA by concentration-dependent manner in 5 day and 7 day incubation, but not in 14 day incubation. CONCLUSIONS: The aminoguanidine could inhibit a new vessel formation in the diabetic retina, and be useful for therapeutic or preventive drug in the diabetic retinopathy.
Blotting, Northern ; Culture Media ; Diabetic Retinopathy ; Epithelial Cells ; Glucose ; Humans ; Hyperglycemia ; Retina ; Retinaldehyde ; RNA, Messenger ; Vascular Endothelial Growth Factor A*

In case of soft-tissue defects with bone and tendon exposure on foot, ankle and lower leg, it is often impossible to achieve wound closure by a simple skin graft. The sural artery flap is a fasciocutaneous flap supplied by the sural artery that accompanies the sural nerve and connects with a septocutaneous perforator of the peroneal artery via a suprafascial network of vessels. For the coverage of the defects, we operated 30 cases using modified superficial sural fasciocutaneous island flap based on the proximal or distal. and we covered convoluted wound site with this flap with plicated fascia. We reconstruct complicated skin defects on the foot region(13) and the distal portion of the leg(17). The size of flap varied from 3 x 4 cm2 to 10 x 9 cm2. All 30 flaps survived completely, but minor complications, such as venous congestion, hematoma disappeared after a few days. The main advantage of this flap is a constant and reliable blood supply without sacrifice of a major artery. but disadvantage of this flap is hypoesthesia at the lateral part of the foot. In conclusion, dissection of the superficial sural fasciocutaneous island flap is quite easy and requires less time, and involves less risk to the patient. The nonbulky fasciocutaneous island flap appearance particularly indicated small to medium sized defects with or without convoluted wound surface. The contours of the recipient and donor sites are acceptable aesthetically.
Ankle ; Arteries ; Fascia ; Foot ; Hematoma ; Humans ; Hyperemia ; Hypesthesia ; Leg ; Skin ; Sural Nerve ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries

BACKGROUNDS AND OBJECTIVE: It has been known that tumor size, regional neck metastasis state and tumor thickness are the prognostic factors of oral cavity or oropharyngeal cancer. Additionally, DNA flow cytometry has also been reported to be one of the pronosic factors. We would like to evaluate the prognostic value of DNA flow cytometry in early oral cavity or oropharyngeal squamous cell carcinoma. MATERIALS AND METHODS: We analyzed the relation between tumor thickness or neck metastasis and survival rate in 59 patients with early oral cavity or oropharyngeal cancer. Among those patients, DNA flow cytometry was performed in 28 cases and the prognostic value of the parameters of DNA flow cytometry was analyzed. RESULTS: Overall, a 2-year survival rate of the patients was 90.1%. Neither tumor thickness nor neck metastasis state was related to the overall survival rate. Tumor thickness was not related to neck metastasis state, either. Of the parameters of the DNA flow cytometry, only the S phase fraction of aneuploidy was related to the overall survival rate (p=0.0288). Also the total proportion of aneuploidy was weakly related to the state of neck metastasis (p=0.0518). CONCLUSION: These results indicate that DNA flow cytometry can be used as a good complementary factor for predicting the overall survival or neck metastasis in patients with early primary oral cavity or oropharyngeal squamous cell carcinoma.
Aneuploidy ; Carcinoma, Squamous Cell* ; DNA* ; Flow Cytometry* ; Humans ; Mouth* ; Neck ; Neoplasm Metastasis ; Oropharyngeal Neoplasms ; S Phase ; Survival Rate

We report a case of renal sarcoidosis accompanied by hypercalcemia and renal insufficiency. A 52-year-old woman presented to hospital with nausea, pruritus, general weakness and weight loss. Laboratory tests revealed a serum creatinine was 3.6mg/dL, calcium ll.lmg/dL(ionized calcium 5.6mg/dL), hemoglobin 10.2g/dL, parathyroid hormone <3.0pg/mL, 24 hour urinary protein 1,127mg/day and 24 hour urinary calcium 489mg/day. Chest X-ray showed normal and both kidneys were within normal size with mild increased echo-genicity on renal ultrasound. Renal biopsy showed interstitial nephritis with mononuclear cell infiltration and mild interstitial fibrosis. Non-caseating granuloma with epitheloid and giant cells were seen. Following corticosteroid therapy, renal function and hypercalcemia were dramatically improved. Within 1 month, calcium level was normal and the creatinine level fell to 2.0mg/dL and subsequently remained stable while corticosteroid was progressively tapered off. She has been followed up for 11 months with normal seum calcium level and the creatinine level of 1.9mg/dL.
Acute Kidney Injury* ; Biopsy ; Calcium ; Creatinine ; Female ; Fibrosis ; Giant Cells ; Granuloma ; Humans ; Hypercalcemia* ; Kidney ; Middle Aged ; Nausea ; Nephritis, Interstitial ; Parathyroid Hormone ; Pruritus ; Renal Insufficiency ; Sarcoidosis* ; Thorax ; Ultrasonography ; Weight Loss

Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric DNA onto the ends of chromosomes. thereby preventing the replication-dependent shortening of these ends. Telomerase activity is detected in a wide range of cancers of various tissues, and its expression may be a critical step in tumor progression. Our objective was to determine if detection of telomerase activity may be an indicator for diagnosis of breast cancer and any association between telomerase activity and prognostic factors of breast cancer. Using a polymerase chain reaction-based telomerase activity assay, we examined telomerase activity in 30 breast cancer specimens (2 ductal carcinoma in situ, 28 invasive ductal carcinoma), 25 benign lesions (14 fibroadenomas, 11 fibrocystic diseases) and 24 normal breast tissues (13 adjacent to malignancy, 11 adjacent to benign lesion). Among surgically resected samples, telomerase activity was detected in 23 (77%) of 30 breast cancers. While telomerase activity was not detected in any of 11 specimens of fibrocystic disease and 11 adjacent normal tissues to benign lesion, surprisingly low levels of telomerase activity were detected in 5 (36%) of 14 fiboadenomas and 1 (7%) of 13 adjacent normal tissues to malignancy. There was no significant difference in expression of telomerase among prognostic factors of breast cancer. In summary, telomerase activity in breast cancer may be useful in diagnosis of breast cancer. We found no correlation between telomerase activity and stage, tumor size or LN status. Mechanisms of telomerase expression are still under investigation; therefore, the significance of telomerase expression in malignant tumors and their progression remains to be determined.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; DNA ; Fibroadenoma ; Humans* ; Ribonucleoproteins ; Telomerase*

Background: Chronic use of glucocorticoid is known to result in osteoporosis. Deflazacort (DFZ), a synthetic glucocorticoid, has been reported to have bone sparing properties in vivo eompared to dexamethasone(DEX). Not only the direct effect of DFZ on human osteoblast but the mechanism by which the drug spares bone remains unclear. This study, therefore, is aimed to investigate the direct effect of DFZ on the proliferation and differentiation of human osteoblast as well as on the gene expression of osteocalcin and osteoblast as well as on the gene expression of osteocalcin and growth factor produced in osteoblast. Methods: Human osteoblast-like cells were cultured from a piece of the tibia removed during selective orthopedic surgery for patients without metabolic bone diseases. The morphological iden- tification of osteoblast-like cell was performed under the light microscope after alkaline phosphatase staining. Cell proliferation rate was determined by [3H] thymidine incorporation into DNA. Cell differentiation was determined by alkaline phophatase activity. mRNA expression was quanti- tatively measured by the competitive reverse transcription-polymerase ehain reaction(RT-PCR). Results: The cultured cells demonstrated 1,25-dihydroxyvitamin D3-induced increases in alkaline phophatase activity and osteocalcin mRNA expression which are the properties of osteoblast. Twenty six percent of the cultured cells were identified as osteoblast-like cells by alkaline phophatase staining. After 24hr incubation with DEX or DFZ, the [3H) thymidine incorporation was significantly inhibited by 100nM DEX or DFL Alkaine phophatase activity was significantly increased by 100nM DEX. Osteocalcin mRNA was significantly decreased by both glueocorticoids. While DEX significantly suppressed expression of asteocalcin mRNA at 10nM and 100nM, DFZ did so only at 100nM. IGF-I mRNA was significantly decreased by 100nM DEX. Conclusion: These results suggest that the inhibitory effect of DFZ on the cell proliferation and protein synthesis is less than that of DEX, which might be responsible for the bone sparing effect of DFZ in vivo.
Alkaline Phosphatase ; Bone Diseases, Metabolic ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Dexamethasone ; DNA ; Gene Expression ; Humans ; Insulin-Like Growth Factor I ; Orthopedics ; Osteoblasts ; Osteocalcin ; Osteoporosis ; RNA, Messenger ; Thymidine ; Tibia

BACKGROUND AND OBJECTIVES: Cyclin-dependent kinase inhibitor (CDKI) is known to play an important role in oncogenesis, but its clinical effect in head and neck cancer has not been reported yet. This study was designed to evaluate the correlation between the pattern of expression in p16 and p21, and tumor progress in laryngeal squamous cell carcinoma. MATERIALS AND METHOD: Paraffin-embedded tissue specimens from 54 patients, who were operated for laryngeal squamous cell carcinoma between Dec. 1990 and Apr. 1997, were immunohistochemically stained for p16 and p21 protein. The clinical features from these patients were retrospectively evaluated. RESULTS: In p16, the proportion of early T stage (T1, T2) and early N stage (N0) was relatively larger in the diffusely staining type than in the other staining pattern; but, the correlation between expression of p16 and T N stage was not significant (p=0.07, 0.65). In p21, proportion of early T stage (T1, T2) and early N stage (N0) was relatively larger in the diffusely staining type than in the other staining pattern; and again, the correlation between expression of p21 and T N stage was not significant (p=0.06, 0.10). CONCLUSION: Other factors were suggested to be strongly related to the clinical aspects of laryngeal squamous cell carcinoma, such as N stage and T stage than p16 and p21. Further study will be needed to understand the role of p16, p21 in oncogenesis of laryngeal squamous cell carcinoma.
Carcinogenesis ; Carcinoma, Squamous Cell* ; Genes, Tumor Suppressor ; Head and Neck Neoplasms ; Humans ; Phosphotransferases ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Galectin-3 is a beta-galactoside binding protein that has been reported to be implicated in numerous biologic and pathologic functions including cell growth, cell adhesion, inflammation, neoplastic transformation, and apoptosis. Most previous studies in thyroid tissue have found galectin-3 expression to be a feature of malignant and not of benign or normal tissue. The aim of this study was to investigate the expression of galectin-3 in 57 thyroid lesions, to assess its potential as a marker in the diagnosis and classification of thyroid malignancy. SUBJECTS AND METHOD: The followings were studied: 19 cases of papillary carcinomas, 8 of follicular carcinomas, one anaplastic carcinoma, one medullary carcinoma, 16 follicular adenomas, and 12 nodular hyperplasia. Formalin-fixed paraffin-embedded thyroid tissues were stained immunohistochemically for galectin-3. RESULTS: Galectin-3 expression was found in all cases, however, it was strong in papillary carcinomas than in follicular carcinomas or adenomas. In nodular hyperplasia, galectin-3 expression was very weak and focal. A significant difference was not found in the expression of galectin-3 between follicular carcinomas and follicular adenomas. CONCLUSION: Galectin-3 is a reliable marker of papillary carcinoma but not useful in identifying follicular carcinoma.
Adenoma ; Apoptosis ; Carcinoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Carrier Proteins ; Cell Adhesion ; Classification ; Diagnosis ; Galectin 3* ; Hyperplasia ; Immunohistochemistry ; Inflammation ; Thyroid Gland*