The angiotensin-converting enzyme (ACE) gene DD homozygote has been suggested to be a significant risk factor for the progression of diabetic nephropathy. We analyzed clinical parameters and ACE genotype distribution between type 2 diabetic patients at the extremes of renal risk, i.e. an end-stage renal failure (ESRF) group (n = 103, group 1) who were on dialysis therapy due to progression of diabetic nephropathy, and a no progression group (n = 88, group 2) who had maintained normal renal function and normoalbuminuria for more than 15 years. There were no significant differences in age, sex, body mass index, HbA1c level, or lipid profiles between the two groups (p > 0.05). Group 1 had a significantly higher prevalence of hypertension [group 1: 82.5% (85/103) vs. group 2: 50.0% (44/88), p < 0.05] and diabetic retinopathy [group 1: 103/103 (100%) vs. group 2: 28/88 (31.8%), p < 0.05] than group 2. Daily urinary albumin excretion was also higher in group 1 than in group 2 [group 1: 2873 +/- 2176 mg/day vs. 12 +/- 7 g/day, p < 0.05]. The frequencies of the DD, ID, and II genotypes of the ACE gene in group 1 and group 2 were 26.2%, 47.6%, and 26.2%, and 7.9%, 57.9%, and 34.2%, respectively. The ACE genotype frequencies between the two groups were significantly different according to a chi-square test with Bonferroni's correction (p = 0.004). The presence of the DD genotype increased the risk of ESRF 4.286-fold compared to the II genotype [odds ratio 4.286, 95% CI 1.60- 11.42, p = 0.005]. The frequency of the D-allele was higher in both male and female patients in group 1 compared to group 2, but reached statistical significance only in males [male, group 1: 50.8% vs. group 2: 35.0%, p = 0.018, female, group 1: 48.8% vs. group 2: 39.5%, p = 0.231]. This study, although limited by sample size, showed that type 2 diabetic ESRF patients more frequently expressed the DD genotype. These findings may substantiate the previously noted relationship between the ACE DD genotype and the progression of diabetic nephropathy in Korean type 2 diabetic patients.
Renal Dialysis ; *Polymorphism, Genetic ; Peptidyl-Dipeptidase A/*genetics/metabolism ; Middle Aged ; Male ; Kidney Failure, Chronic/diagnosis/*genetics ; Humans ; Homozygote ; Gene Frequency ; Female ; Diabetic Nephropathies/diagnosis/*genetics ; Diabetes Mellitus, Type 2/diagnosis/*genetics ; Aged

PURPOSE: To investigate clusterin expression in the acini and ductal cells of rat submandibular glands after Co-60 gamma irradiation. MATERIALS AND METHODS: The male Sprague-Dawley rats weighing approximately 250 gm were divided into control and experimental groups. The experimental group was irradiated with a single absorbed dose of 2, 5, 10, and 15 Gy on the head and neck region. All the rats were sacrificed at 1, 3, 7, 14, 21, and 28 days after irradiation. The specimens including the submandibular gland were sectioned and observed using a immunohistochemical method. RESULTS: In the 2 Gy group, clusterin expression was similar to that of the control group at 1 day after irradiation and it was observed in the striated ductal cells at 3 days after irradiation. In the 5 Gy group, clusterin expression was observed in the striated ductal cells at 1 day after irradiation and gradually increased in the 10 and 15 Gy groups. In the 15 Gy group, clusterin expression was prominent in the striated ductal cells at 1 day after irradiation, but it gradually decreased with the experimental period. The destruction of the striated ductal cells was observed in the 2 Gy group at 21 days after irradiation and in the 5, 10, and 15 Gy groups at 7 days after irradiation. The destruction of the acinar cells was observed in the 2 Gy group at 28 days after irradiation and in the 5, 10, and 15 Gy groups at 14 days after irradiation. CONCLUSION: Clusterin expression was induced by low doses of irradiation and it appeared to be involved in the regulation of cellular response to irradiation.
Acinar Cells ; Animals ; Apoptosis ; Clusterin* ; Head ; Humans ; Male ; Neck ; Rats* ; Rats, Sprague-Dawley ; Salivary Glands* ; Submandibular Gland

PURPOSE: To investigate the caspase-3 expression in the acinar and ductal cells of rat submandibular glands after the irradiation of various doses. MATERIALS AND METHODS: The male Sprague-Dawley rats weighing approximately 250 gm were used for this study. The experimental group was irradiated with a single absorbed dose of 2, 5, 10, and 15 Gy on the head and neck region. The rats were sacrificed on the 1st, 3rd, 7th, 14th, 21st, and 28th day after irradiation. The specimens including the submandibular gland were sectioned and observed using histopathological and immunohistochemical methods. RESULTS: The local destruction of the acinar and ductal cells and the karyopyknotic nuclei of the acinar cells were observed in the 2 Gy and 5 Gy irradiation groups later than in the 10 Gy and 15 Gy irradiation groups. And the expression of caspase-3 was prominent only in the ductal cells in the 2 Gy and 5 Gy irradiation groups. CONCLUSION: This experiment suggests that radiation-induced apoptosis in the ductal cells of rat submandibular glands was induced by a low dose radiation associated with the activation of caspase-3 and radiation-induced necrosis was induced by a high dose radiation.
Acinar Cells ; Animals ; Apoptosis ; Caspase 3* ; Head ; Humans ; Male ; Neck ; Necrosis ; Rats* ; Rats, Sprague-Dawley ; Submandibular Gland*

Pterygium is a proliferative disease. Recent research has reported that stem cells are involved in the pathogenesis of various proliferative diseases, including solid tumors and diabetic proliferate vitreoretinopathy. In previous literature, we hypothesized that adult stem cells originated from bone marrow were involved in the pathogenesis of pterygium. We proved this by immunohistochemical staining with various stem cell markers. The staining showed adult stem cells in the pterygium. c-kit positive cells were observed primarily in the stroma, and some cells were also found in the basal epithelium. AC133 and CD34 positive cells were primarily found in the basal epithelium and were ovoid shaped, similar to the c-kit cells. However, some cells were found in vascular endothelium. STRO-1 positive cells were found mainly in the stroma and were spindle shaped. In recurrent pterygium, cells were more scattered and the expression pattern was denser. Therefore, we suggest a new theory of pterygium pathogenesis. Inflammation caused by environmental factors triggers the abnormal production of some growth factors and cytokines in order to recover from cellular damage. If these healing signals are excessive, limbal basal cells will be changed to abnormally-altered pterygial cells. The excessive wound healing process and remnant altered cells result in recurrence using the same mechanism.
Stem Cells/*physiology ; Pterygium/*etiology ; Proto-Oncogene Proteins c-kit/analysis ; Peptides/analysis ; Middle Aged ; Humans ; Glycoproteins/analysis ; Bone Marrow Cells/*physiology ; Antigens, CD34/analysis ; Antigens, CD/analysis

OBJECTIVES: The goal of this study is to observe the anatomy around the maxillary sinus ostium and gain an understanding that will help prevent serious complications during middle meatal antrostomies. MATERIALS AND METHODS: Dissection of the maxillary sinuses was carried out in 64 embalmed frozen cadavers, 105 maxillary sinuses. Using a digital ruler, forceps and a malleable probe, we measured the important anatomical relationships around the maxillary sinus ostium and uncinate process, the accessory ostium, and the nasolacrimal duct. RESULTS: 1) The mean width of the uncinate process was 4.9 mm in the mid portion ; 2) A natural ostium of the canal type was observed in 76% of cases ; 3) An accessory ostium was found in 18% of cases and the mean size was 3.17x2.41 mm ; and 4) The mean shortest distance between the nasolacrimal duct and the natural ostium was 4.8 mm. CONCLUSION: Surgeons must keep surgical anatomy in mind to prevent complications when performing endoscopic sinus surgery.
Cadaver* ; Maxillary Sinus* ; Nasolacrimal Duct ; Surgical Instruments

To understand the seroepidemiological patterns of haemorrhagic fever with renal syndrome in Korea, a nation-wide survey collaborated with fourteen clinics was carried out from 1994 to 1996. Sera of 4,547 patients with acute febrile episodes were tested by indirect immunofluorescent antibody test and the seroepidemiological analysis including sex, age, seasonal and regional distributions were performed. According to the results obtained in this study, the epidemiological characteristics of haemorrhagic fever with renal syndrome in Korea were summarized as follows: 1. Seropositive rate of hemorrhagic fever with renal syndrome among the patients with acute febrile episodes was 6.4% by the cut-off point of 1:40. 2. Among the seropositives, male outnumbered female and the ratio of males to females was 2.0:1.0. 3. Seventy six % of the seropositive patients were 21-60 years old. 4. The number of seropositive cases increased from October and reached maximum in December and began to decrease gradually from January. 5. The geographical distribution of the seropositives cover most areas including Cheju province in Korea.
Female ; Fever ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Jeju-do ; Korea* ; Male ; Seasons

Frontal sinusitis can lead to severe and life-threatening disorders. Complications may involve intracranial structures, orbit and adjacent bone and soft tissue structures. Bone wax has been used since the turn of the century as a mechanical aid to hemostasis following surgical procedures. That it may produce a foreign body giant cell reaction in significant proportion of cases is well known. We experienced a woman who had recurrent frontal sinusitis due to bone wax. She was treated by endoscopic frontal sinusotomy with foreign body removal.
Female ; Foreign Bodies ; Frontal Sinus* ; Frontal Sinusitis* ; Giant Cells, Foreign-Body ; Hemostasis ; Humans ; Orbit

The effects of intraventricular atropine on the heart rate was investigated in the rabbit. Intraventricular administration of atropine in a dose of 10, 30, 100, or 300 ug produced dose dependant bradycardia. Atropine (100 ug) induced bradycardia was abolished by bilateral vagotomy or intravenous atropine, and inhibited by intravenous propranolol but not by intravenous Regitine. Intraventricular Ecolid or regitine pretreatment diminished the bradycardia induced by intraventricular atropine. From the above results, it is suggested that a central adrenergic mechanism as well as vagal activity plays an important role in the intraventricular atropine-induced bradycardia.
Atropine* ; Bradycardia ; Chlorisondamine ; Heart Rate* ; Heart* ; Phentolamine ; Propranolol ; Vagotomy

PURPOSE: To determine the relationship between clinical symptoms and magnetic resoncance (MR) images in patients presenting with temoporomandibular joint (TMJ) disorders. MATERIALS AND METHODS: This study was based on 172 joints in 86 patients presenting with TMJ disorders. Joint pain and sound during jaw opening and closing movements were recorded, and the possible relationship between disc positions and bony changes of the condylar head and the articular fossa in MR images in the oblique sagittal planes were examined. Data were analyzed by Chi-square test. RESULTS: There was no statistically significant relationship between clinical symptoms and MR images in the patients with TMJ disorders. CONCLUSION: In the patient with TMJ disorders, joint pain and sound could not be specific clinical symptoms that are related with MR image findings, and asymptomatic joints did not necessarily imply that the joints are normal according to MR image findings.
Arthralgia ; Head ; Humans ; Jaw ; Joints ; Magnetic Resonance Imaging ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*

PURPOSE: Recently, a self-expandable metallic stent has allowed an elective single-stage resection avoiding the risk of emergency operation and stoma formation in patients with obstructive colorectal cancer (CRC). But, forceful expansion of stent may increase the possibility of tumor cell exfoliation and dissemination through bowel lumen, lymphatic and blood vessels. Aim of study is to evaluate the short-term outcome of curative resection for obstructive colorectal cancer followed by stent in terms of oncologic safety. METHODS: Twenty-seven patients who underwent curative resection for obstructive CRC followed by stent insertion were included in 'stent group' and control group included 87 patients who underwent surgery for non-obstructive CRC. The clinicopathologic characteristics and prognosis were compared between two groups. RESULTS: There was no significant difference in clinicopathologic characteristics between two groups. No difference was found in postoperative complications between two groups. Overall survival rate of two groups showed no statistically significant differences (P=0.1254). Stage-matched survival rates (stage II & III) were also showed no differences between two groups. CONCLUSION: Stent insertion itself does not compromise the survival of patients with obstructive CRC. Oncologic safety of stent insertion for obstructive CRC is acceptable. A further large-scaled prospective study and long-term follow-up is necessary to evaluate the oncologic safety of stent insertion in obstructive CRC.
Blood Vessels ; Colorectal Neoplasms ; Emergencies ; Follow-Up Studies ; Humans ; Postoperative Complications ; Prognosis ; Stents ; Survival Rate