BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

PURPOSE: A large number of studies have demonstrated that rhinitis and asthma commonly occur together, and that a temporary relationship between the onset of rhinitis and asthma with rhinitis frequently preceding the development of asthma. We studied to know whether there were asthmatic airway inflammations in subjects with allergic rhinitis with bronchial hyperresponsiveness to methacholine who had no asthma symptoms. METHODS: Thirty seven children with an allergic rhinitis who visited the pediatric allergy clinic from January 1998 through June 1999 were enrolled. They were grouped into two groups according to the degree of airway responsiveness to methacholine, and 19 bronchial asthma patients with had no asthma attacks for 2 months were compared as control group.; AR-Mch (+) group (n=19) had a PC20-Methacholine lower than 10 mg/mL: AR-Mch (-) group (n=18) had a PC20-Metacholine greater than 10 mg/mL. The relationship of PEFR variability, sputum eosinophils, and nasal eosinophils with bronchial hyperresponsiveness to methacholine in each groups was compared. RESULTS: 1) The PC20-Methacholine was 5.7+/-3.5 mg/mL in the AR-Mch (+) Group, 1.9+/-2.7 mg/mL in the BA Group. 2) Sputum eosinophil was 14+/-6.9% in the AR-Mch (+) Group, 8.1+/-5.2% in the AR-Mch (-) Group, 29.6+/-16.9% in the BA Group, and sputum eosinophils of the AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 3) PEFR dinural variation was 7.0+/-2.6% in the AR-Mch (+) Group, 5.0+/-2.9% in the AR-Mch (-) Group, 14.0+/-6.0% in the BA Group, and PEFR dinural variation in AR-Mch (+) Group was higher than that of the AR-Mch (-) Group. 4) The PC20-Methacholine was not correlated with PEFR dinural variation in both the AR-Mch (+) Group and the BA Group. 5) The PC20-Methacholine was correlated with sputum eosinophils only in the BA Group. 6) Nasal eosinophils were not correlated with sputum eosinophils in the AR-Mch (+) and the BA Group. CONCLUSIONS: This study demonstrated that patients with allergic rhinitis who had bronchial hyperresponsiveness to methacholine might have eosinophilic inflammation in the lower airway and increased dinural PEFR. Further studies are necessary to evaluate whether asthma symptoms will be developed in these allergic rhinitis children.
Asthma ; Child* ; Eosinophils ; Humans ; Hypersensitivity ; Inflammation ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Rhinitis* ; Sputum*

Idiopathic central serous chorioretinopathy is localized detachment of the neurosensory retina in the macula which is commonly seen. However extensive sensory retinal detachment of the posterior role and multiple leaking points are rare characteristics of idiopathic central serous chorioretinopathy. Idiopathic central serous chorioretinopathy with bullous retinal detachment is frequently misdiagnosed and treated improperly. The authors experienced a case of atypical type of idiopathic central serous chorioretinopathy that has bullous retinal detachment and multiple Ieaking points in the both eyes.
Central Serous Chorioretinopathy* ; Retina ; Retinal Detachment* ; Retinaldehyde*

BACKGROUND: Cyclooxygenase-2 (COX-2) is an enzyme that promotes proliferation of tumor cells. HuR is a member of the family of embryonic lethal abnormal vision-like proteins. Recent studies show that cytoplasmic HuR stabilizes the mRNA of COX-2 and regulates the expression of COX-2. Moreover, cytoplasmic HuR expression is associated with a poorer prognosis for patients with some cancers. The aim of this study was to investigate the expression patterns of and the relationship between COX-2 and HuR in gallbladder carcinoma. METHODS: We analyzed COX-2 and HuR expression by immunohistochemical staining of 108 gallbladder carcinomas. RESULTS: COX-2 expression and nuclear and cytoplasmic HuR expression were seen in, respectively, 61 (56.5%), 77 (71.3%), and 4 (3.7%) cases. COX-2 and nuclear HuR were simultaneously expressed in 44 of the 108 samples without any quantitative association between the levels of each. COX-2 expression correlated with tumor stage, differentiation (based on histology), lymph node metastasis, perineural invasion, and survival. Nuclear and cytological expression of HuR did not correlate with any clinical parameters. CONCLUSIONS: COX-2 expression but not HuR may play an important role in the prognosis of patients with gallbladder carcinoma.
Cyclooxygenase 2 ; Cytoplasm ; Gallbladder ; Gallbladder Neoplasms ; ELAV Proteins ; ELAV-Like Protein 1 ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Proteins ; RNA, Messenger

Three hundred renal transplantations were performed by the transplantation team in the Kosin Medical College from December, 1984 to August, 1993. Prognosis and complications with affecting factors and demographic data were analysed and the results were as follows; 1. In 300 recipients, 206 cases were male and 94 cases were female. 146 cases were male and 154 cases were female in 300 donors 2. All 300 cases were living transplantations ; among them, 207 cases were related and 93 cases were unrelated donors. 3. The most common underlying disease of recipients was chronic glomerulonephritis (89%). 4. In 263 donors, the left kidney was selected for graft. 5. For donor nephrectomy, flank incision( anterior incision) was used in all cases and among them 12th transcostal incision was made in 134 cases. 6. For ureteroneocystostomy, modified MacKinnon`s method was performed in 297 cases and Politano-Leadbetter procedure was used in only 3 cases. 7. Postoperative urologic complications occurred in 26 cases( 8.3%) ; perirenal hematoma, 16 cases for which revision was done; urine leakage, 8 cases for which 6 cases needed revision. 8. Complications of donor nephrectomy occurred in 8 cases( 2.6%) ; retroperitoneal hematoma, 2 cases; pneumothorax, 2 cases; pleural effusion, atelectasis, ulcer perforation and stress ulcer, one case respectively. 9. The survival rate for the graft was 91.6% for one year, 88.1 % for 2 years, 81.5% for 3 years, 77.7% for 4 years and 74.3% for 5 years. The survival rates of the recipients were 94.4%, 93.6%, 91.4%, 89.7% and 89.7% according to each year respectively.
Female ; Glomerulonephritis ; Hematoma ; Humans ; Kidney ; Kidney Transplantation* ; Male ; Nephrectomy ; Pleural Effusion ; Pneumothorax ; Prognosis ; Pulmonary Atelectasis ; Survival Rate ; Tissue Donors ; Transplants ; Ulcer ; Unrelated Donors

BACKGROUND AND OBJECTIVES: It is known that a part of laryngeal premalignant lesions progresses to an invasive carcinoma. Despite many previous reports, conventional histology is not sufficient to predict such tumor progression. Herein, the authors investigated the role of CD44v3 as a biomarker in predicting the progression of laryngeal premalignant lesion to an inavasive cancer. SUBJECTS AND METHOD: Paraffin-embedded tissue specimens from 40 patients were diagnosed accordingly as laryngeal invasive squamous cell carcinoma (n=10), Carcinoma in situ (n=10), dysplasia (n=10), and hyperkeratosis (n=10) between 1993 and 2002. They were immunohistochemically stained for CD44v3 protein. RESULTS: In invasive squamous cell carcinoma, the expression of CD44v3 was diffused and gave a strong positive stain, and in carcinoma in situ, it was diffused and gave 3+-2+ stain. However, in dysplasia and hyperkeratosis, the proportion of CD44v3 expression was decreased by 2+-1+, and 1+-0, respectively. CONCLUSION: These results suggest that the expression of CD44v3 in laryngeal premalignant and malignant lesions can be associated with tumorigenesis and invasion. Those strong positive expressions of CD44v3 may represent more aggressive pathology of the larynx.
Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Humans ; Larynx* ; Pathology

Background and Objectives: Claudin-1 (CLDN-1) is the major component of tight junctions and functions in controlling cell to cell adhesion. Certain claudins were expressed aberrantly and proved to have prognostic significance in various human cancers. However, its clinical significance has been poorly understood in head and neck squamous cell carcinoma (HNSCC). The aim of this study was to investigate the relationship between CLDN-1 expression and clinicopathologic parameters in HNSCC.Subjects and Method The surgical specimens of primary HNSCCs from a consecutive cohort of 91 patients were retrospectively collected. Immunohistochemical staining for CLDN-1 was performed blindly by two pathologists. CLDN-1 staining intensity was scored semi-quantitatively on a scale of 0 to 3 (0: negative; 1: weak; 2: moderate; 3: strong). For the statistical analysis, the expression levels were classified as low (negative and weak) and high (moderate and strong). Next, the association between CLDN-1 expression and clinicopathological features & clinical outcomes was analyzed. Results: The increased CLDN-1 expression was significantly associated with lymphatic invasion (p=0.019). The expression level of CLDN-1 was not associated with pathological T stage, lymph node metastasis or recurrence. Kaplan-Meier analysis found that 3-year overall survival (OS) rate was 53% in patients with high level CLDN-1 expression and 74% in patients with low level CLDN-1 expression. It also found that 5-year OS rate was 49% in patients with high level CLDN-1 expression and 68% in patients with low level CLDN-1 expression. A significantly poor OS rate was recorded in patients with high level of CLDN-1 expression compared to patients with low level CLDN-1 expression (p=0.022). Conclusion CLDN-1 may serve as useful prognostic marker in patients with HNSCCs.

BACKGROUND: Embryonic lethal abnormal vision (ELAV)-like protein HuR is known to stabilize mRNA through binding AU-rich elements in the 3'-untranslated region. Recent studies show that HuR expression is associated with the expression of several genes including cyclooxygenase-2 (COX-2). HuR exists predominantly in the nucleus, but cytoplasmic translocation of HuR is thought to be more important for its activity. COX-2 is a well-known enzyme that promotes tumor growth. METHODS: To evaluate the correlation of HuR and COX-2 expression, we analyzed expression of HuR and COX-2 in 91 cases of breast cancer using immunohistochemistry. RESULTS: Nuclear and cytoplasmic expression of HuR was seen in 76 (83.5%) and 19 (20.9%) of 91 cases respectively. COX-2 immunoreactivity was seen in 54 (59.4%) cases. Cytoplasmic HuR expression showed significant correlation with COX-2 expression (p=0.001). Nuclear HuR showed no correlation with COX-2 expression or other clinicopathological parameters. COX-2 expression is significantly associated with tumor grade (p=0.028). COX-2 (p=0.092) and cytoplasmic (p=0.569) and nuclear HuR (p=0.247) expression showed no correlation with survival. CONCLUSIONS: These results suggest that cytoplasmic HuR expression is associated with COX-2 expression in breast cancer and cytoplasmic location of HuR might contribute to the stabilization of COX-2 mRNA.
Breast Neoplasms

PURPOSE: We investigate the age-related changes in the production of nitiric oxide (NO) in the articular cartilage and its effects on cell proliferation. MATERIALS AND METHODS: Forty New Zealand white rabbits of four different age groups were used. There were 10 rabbits in each group and the age groups were 1 month, 6 months, 1 year and 3 years of age. We measured the basal and induced production of NO in cultured articular chondrocytes that were obtained from distal femur by using a nitrite assay. We observed the changes in the proliferative activity of the chondrocytes after exogenous NO administration using a nonradioisotopic proliferation assay. In addition, we also detected endothelial nitric oxide synthase (eNOS) in articular cartilage using immunohistochemical staining. RESULTS: The basal and induced levels of NO were lower in the cultured chondrocytes from older rabbits. Exogenous NO administration suppressed the proliferative activity of chondrocytes to a greater degree in the younger rabbits than in the older ones. Immunohistochemistry showed a predominance of eNOS positive chondrocytes in the superficial layer. The number of eNOS positive chondrocytes decreased in older rabbits. CONCLUSION: The production of NO decreased with aging in normal articular cartilage. The suppression of proliferative activity in chondrocytes by exogenous NO declined with aging.
Aging* ; Cartilage, Articular* ; Cell Proliferation ; Chondrocytes ; Femur ; Humans ; Immunohistochemistry ; Nitric Oxide Synthase Type III ; Nitric Oxide* ; Rabbits

Adenoid cystic carcinoma of the salivary gland is an indolent tumor with an unfavorable long-term prognosis. Dedifferentiation of adenoid cystic carcinoma, which is associated with an accelerated clinical course, has recently been described. Histologically, the low-grade adenoid cystic carcinoma merge gradually into an extensive dedifferentiated component composed of solid sheets and cords of anaplastic tumor cells with focal gland formation. We experienced dedifferentiation in adenoid cystic carcinoma of the submandibular gland and report it with a review of the literature and immunohistochemical workup to elucidate the likely mechanism of dedifferentiation.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Neck* ; Prognosis ; Salivary Glands ; Submandibular Gland