In patients with renal transplant failure's the graft can be left in situ when there are no additional complications. Graft intolerance occurs in some failed renal grafts when the immunological treatment is completely withdrawn. We experienced a case of graft intolerance syndrome in a patient with renal graft failure treated by percutaneous renal artery embolization. A 31 year -old man was admitted at nephrology department because of fever and hematuria without other infection focus. He was diagnosed as graft intolerance syndrome and treated by percutaneous embolization of the failed renal allograft. The embolization was successful. He suffered from post-emboization syndrome and treated by sulindac. We report this case with a review of relevant literatures and conclud that percutaneous renal artery embolizaion is a simple, safe and effective technique for the treatment of nonfunctioning renal allograft with clinical intolerance. Surgical nephrectomy should be reserved as a second level of treatment when allograft embolization has been ineffective owing to reappearance of manifestations of clinical intolerance.
Allografts ; Fever ; Hematuria ; Humans ; Nephrectomy ; Nephrology ; Renal Artery* ; Sulindac ; Transplants*

PURPOSE: To determine the usefulness of CT for the evaluation of peripheral bronchopleural fistulas. MATERIALS AND METHODS: CT scans of 22 patients with persistent air leak, as seen on serial chest PA, and aclinical history, were retrospectively evaluated. We determined the visibility of direct communication between thelung and pleural space, and the frequeucy and location of this, and if direct communications were not visualizedthe probable cause. RESULTS: A bronchopleural fistula(n=13) or its probable cause(n=6) was visualized in 19patients(86%). Direct communications between the lung and pleural space were seen in 13 patients(59%); there weresix cases of tuberculous empyema, three of tuberculosis, two of necrotizing empyema, one of trauma, and one ofpostobstructive pneumonitis. In six patients, bronchiectatic change in peripheral lung adjacent to the pleuralcavity was noted, and although this was seen as a probable cause of bronchopleural fistual, direct communicationwas invisible. Bronchopleural fistula or its probable cause was multiple in 18 of 19 patients, involving the upperand lower lobe in eight, the upper in nine, and the lower in two. CONCLUSIONS: CT is useful for evaluating thepresence of bronchopleural fistula, and its frequency and location, and in patients in whom the fistula is notdirectly visualized, the cause of this.
Empyema ; Empyema, Tuberculous ; Fistula* ; Humans ; Lung ; Pneumonia ; Retrospective Studies ; Sulindac ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis

Familial adenomatous polyposis(FAP) is an autosomal dominant disease characterized by numerous adenomas in the colorectum. Patients with FAP are always at risk of malignant transformation, so that colectomy is unavoidable. NSAID, such as sulindac, and selective COX-2 inhibitor, such as celecoxib, have shown a positive effect on FAP by causing polyp regression in some patients. We report a case of FAP in a 9-year-old female whose polyposis regressed markedly after six months-treatment with celecoxib.
Adenoma ; Adenomatous Polyposis Coli* ; Child* ; Colectomy ; Female ; Humans ; Polyps ; Sulindac ; Celecoxib

This study was performed to examine the effect of a 7-week comprehensive health promotion program for improving pain, depression, and disability by employing a quasi-experimental design. The subjects were regular out-patients of a RA aclinic in an University Hospital in Inchon from November 11. 1998 to December 24. 1998. The Experimental group included 18 patients who participated in an arthritis health promotion program, and the control group included 18 patients who did not. The 7-week health promotion program, which had the objective to enhance health promoting skills, was provided to patients. The effects of this program on the patients' pain, depression, and functional disability were examined. According to the study results, a significant group difference was found on these dependent variables (Hotelling's T =.30, F=3.11, p=.04). To examine which dependent variables had significant effects, one-way ANOVAs were performed. There were significant group differences in pain (F=4.35, p=.05) and in depression (F=4.22, p=.05) However, no significant group differences on functional disability (F=.04, p=.84) were found. Conclusively, the arthritis health promotion program, which was designed to enhance 11 health promoting skills, can be evaluated as successfully achieving the ultimate goal of enhancing the patients' quality of life. It can also be contended that the improvement of the patients' quality of life was enabled by relieving pain and reducing depression.
Arthritis ; Arthritis, Rheumatoid* ; Depression ; Health Promotion* ; Humans ; Incheon ; Outpatients ; Quality of Life ; Sulindac

This study was performed to examine the effect of a 7-week comprehensive health promotion program for improving pain, depression, and disability by employing a quasi-experimental design. The subjects were regular out-patients of a RA aclinic in an University Hospital in Inchon from November 11. 1998 to December 24. 1998. The Experimental group included 18 patients who participated in an arthritis health promotion program, and the control group included 18 patients who did not. The 7-week health promotion program, which had the objective to enhance health promoting skills, was provided to patients. The effects of this program on the patients' pain, depression, and functional disability were examined. According to the study results, a significant group difference was found on these dependent variables (Hotelling's T =.30, F=3.11, p=.04). To examine which dependent variables had significant effects, one-way ANOVAs were performed. There were significant group differences in pain (F=4.35, p=.05) and in depression (F=4.22, p=.05) However, no significant group differences on functional disability (F=.04, p=.84) were found. Conclusively, the arthritis health promotion program, which was designed to enhance 11 health promoting skills, can be evaluated as successfully achieving the ultimate goal of enhancing the patients' quality of life. It can also be contended that the improvement of the patients' quality of life was enabled by relieving pain and reducing depression.
Arthritis ; Arthritis, Rheumatoid* ; Depression ; Health Promotion* ; Humans ; Incheon ; Outpatients ; Quality of Life ; Sulindac

Desmoid tumor is a subtype of fibromatosis arising from deep fascial or soft tissue structure. It is characterized by locally aggressive behavior with a tendency to local recurrence, but is generally accepted the lack of ability for distant metastasis. Although excision is the best initial therapy, surgery is not always amenable in cases of lesions lying in difficult anatomical area. Two female patients with recurrent desmoid tumor in abdomen and pelvis after excision were treated with tamoxifen, goserelin, and sulindac. This therapy led to a progressive decrease of tumor size within 13 months in one patient. However, in the other patient, this combined therapy failed to reduce the size of the tumor. Despite the success of combined therapy with hormone and nonsteroidal anti-inflammatory drug is anecdotal, this treatment may improve the survival and reduce the recurrence in certain sub-group of desmoid tumor.
Abdomen* ; Deception ; Female ; Fibroma ; Fibromatosis, Aggressive* ; Goserelin* ; Humans ; Neoplasm Metastasis ; Pelvis ; Recurrence ; Sulindac* ; Tamoxifen*

Osteosarcoma is a malignant tumor arising from the undifferentiated fibrous tissue of bone and one of the mostcommon pirmary malignant tumors of bone. The diagnosis of osteosarcoma is based one can be diagnosed with areasonable degree of confidence from the conbination of the lesion site, age and radiological findings. This is aclinical and radiological observation of 40 cases of osteosarcoma which were experienced at Chonnam NationalUniversity Hospital, Chosum University Hospital and Kwangju Christian Hospital from 1978 to 1981. The results wereas follows; 1. The peak incidence was in the age group from 10 to 19 years in 21 cases (52.5%). 2. In sexdistribution, male group showed slightly higer incidence than in female group with the ratio of 1.35;1. 3. Themost commonly affected site was proximal tibia(35%). The lesion was found around the knee in 65% of the studiedcases. 4. Increment of the level of serum alkaline phosphase was observed in 25 cases (62.5%), and the averagevalue of serum alkaline phosphature in these cases was 5.6 Bessay Lowry units. 5. Radiographically, osteoblastictype was 14 cases (35%), and soft tissue mass shadow with calcification was observed in 34 cases (85%). 6.Cortical destruction was observed in 30 cases (75%), and soft tissue mass shadow with calcification was observedin 34 cases (85%). 7. Solid periosteal reaction, sunburst periosteal reaction and Codman's triangle were observedin 35%, 57.5% and 22.5% respectively. 8. At the first visit, lung meatastasis was found in 5 cases (12.5%) andinguinal lymphnode metastasis in 2 cases (5%)
Diagnosis ; Female ; Gwangju ; Humans ; Incidence ; Jeollanam-do ; Knee ; Lung ; Male ; Neoplasm Metastasis ; Osteosarcoma ; Sulindac

PURPOSE: To evaluate the characteristic MR findings of hemophilic arthropathy of the knee. MATERIALS & METHOD: Seven knees in six patients with hemophilia (five hemophilia A and one hemophilia B) were retrospectively studied with MR images and plain radiographs. Patients were aged between 2 and 20 years (mean, 11) and all had a clinical history of repeated hemarthrosis. MR images of the knee were analyzed with respect to intra- andextra-articular hemorrhage, the state of synovial tissue, articular cartilage, bone, menisci, and ligaments. RESULTS: Synovial hypertrophy and articular cartilage destruction were revealed in all seven knees ; pannus wasfound in four, and was seen as low signal intensity on T1-weighted image and high signal intensity on T2-weighted images. All five instances of synovial hypertrophy and pannus were enhanced. Joint effusion, presented in five ofseven knees, demonstrated slightly low signal intensity on T1-weighted image and high signal intensity on T2-weighted images, and was associated with peripheral low signal intensity of hemosiderin. Subchondral and marginal erosion was seen in six cases, patellar deformity in three, meniscal damage in four and cruciate ligament damage in one case. CONCLUSION: MR is superior to plain radiography in demonstrating chronic repeated hemarthrosis (manifested as thick intra-articular effusion), hemosiderin, synovial hypertrophy, erosion ordestruction of articular cartilage and bone, and meniscal or cruciate ligament injury of hemophilic arthropathy ofthe knee. MR is therefore thought to be a useful imaging study for accurate evaluation of hemophilic arthropathyof the knee.
Cartilage, Articular ; Congenital Abnormalities ; Hemarthrosis ; Hemophilia A ; Hemorrhage ; Hemosiderin ; Humans ; Hypertrophy ; Joints ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Radiography* ; Sulindac

PURPOSE: One of possible mechanisms of the antineoplastic effect by nonsteroidal anti-inflammatory drugs (NSAIDs) is an induction of apoptosis. The NSAIDs-induced apoptosis appears to be caspase- and mitochondria-dependent. The ubiquitin-proteasome system, which is a fundamental non- lysosomal tool that cells use to process or degrade a variety of short-lived proteins, is known to be involved in apoptosis and to be located upstream of mitochondrial changes and caspase activation. The present study was conducted to explore the potential role of proteasome pathway in NSAIDs-induced apoptosis. METHODS: We employed sulindac as a NSAID, and the lactacystin as a proteasome inhibitor to investigate the extent of the apoptosis in colon cancer cell line, HT-29 cells. The proteasome activity and the amount of apoptosis were quantified after cells were treated with 1 mM sulindac, 1micrometer lactacystin or both. RESULTS: Sulindac treatment caused apoptosis of the HT-29 cells in a time-dependent manner with resultant changes in nuclear morphology. Western blots also showed caspase-3 activation and PARP cleavage after sulindac treatment. Not only single treatment with lactacystin decreased proteasome activity, but co-treatment with sulindac enhanced decrease in proteasome activity further (P<0.01). Treatment with lactacystin only did not induce apoptosis. However, lactacystin augmented the induction of sulindac-induced apoptosis (P<0.01). This synergistic effect was also proven by Western blot analyses, where co-treatment augmented the caspase-3 activation and PARP degradation. CONCLUSIONS: The combination treatment of sulindac with a proteasome inhibitor lactacystin is suggested to be a very effective strategy for the induction of cancer cell apoptosis. Elucidation of the mechanism underlying the regression of colon cancers by combination of sulindac and lactacystin seems to be an immediate challenge in the near future.
Apoptosis* ; Blotting, Western ; Caspase 3 ; Cell Line ; Colonic Neoplasms ; HT29 Cells* ; Humans ; Proteasome Endopeptidase Complex ; Proteasome Inhibitors ; Sulindac

Familial adenomatous polyposis (FAP) is an autosomal dominant disorder characterized by hundreds of colorectal adenomatous polyps that progress to colorectal cancer. Management of patients with FAP is with a total colectomy. Chemopreventive strategies have been studied in FAP patients in an effort to delay the development of adenomas in the upper and the lower gastrointestinal tract and to prevent recurrence of adenomas in the retained rectum of patients after prophylactic surgery. Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients. However, evidence regarding long-term use of this therapy and its effect on the intact colon has been insufficient. We report a case in which the long-term use of sulindac was effective in reducing the size and the number of colonic polyps in patients with FAP without a prophylactic colectomy and polypectomy; we also present a review of the literature.
Adenoma* ; Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Chemoprevention ; Colectomy* ; Colon* ; Colonic Polyps ; Colorectal Neoplasms ; Follow-Up Studies* ; Humans ; Lower Gastrointestinal Tract ; Rectum ; Recurrence ; Sulindac*