OBJECTIVE: To elucidate the role of aquaporin-4(AQP4) in cerebral edema formation, we studied the expression and subcellular localization of AQP4 in astrocytes after focal cerebral ischemia. METHODS: Cerebral ischemia were induced by permanent middle cerebral artery(MCA) occlusion in rats and estimated by the discoloration after triphenyltetrazolium chloride(TTC) immersion. Change of AQP4 expression were evaluated using western blot. Localization of AQP4 was assessed by confocal microscopy and its interaction with alpha-syntrophin was analyzed by immunoprecipitation. RESULTS: After right MCA occlusion, the size of infarct and number of apoptotic cells increased with time. The ratio of GluR1/GluR2 expression also increased during ischemia. The polarized localization of AQP4 in the endfeet of astrocytes contacting with ventricles, vessels and pia mater was changed into the diffuse distribution in cytoplasm. The interactions of AQP4 and Kir with alpha-syntrophin, an adaptor of dystrophin complex, were disrupted by cerebral ischemia. CONCLUSION: The deranged spatial buffering function of astrocytes due to mislocalized AQP4/Kir4.1 channel as well as increased assembly of Ca2+ permeable AMPA receptors might contribute to the development of edema formation and the excitotoxic neuronal cell death during ischemia.
Animals ; Apoptosis ; Aquaporin 4 ; Astrocytes ; Blotting, Western ; Brain Edema* ; Brain Ischemia* ; Cell Death ; Cerebral Infarction ; Cytoplasm ; Dystrophin ; Edema ; Immersion ; Immunoprecipitation ; Ischemia ; Microscopy, Confocal ; Neurons ; Pia Mater ; Rats* ; Receptors, AMPA ; Receptors, KIR

OBJECTIVE: Activated endothelial cells mediate the cascade of reactions in response to hypoxia for adaptation to the stress. It has been suggested that hypoxia, by itself, without reperfusion, can activate the endothelial cells and initiate complex responses. In this study, we investigated whether hypoxia-induced endothelial products alter the endothelial permeability and have a direct cytotoxic effect on nerve cells. METHODS: Hypoxic condition of primary human umbilical vein endothelial cells(HUVEC) was induced by CoCl2 treatment in culture medium. Cell growth was evaluated by 3,4,5-dimethyl thiazole-3,5-diphenyl tetrazolium bromide (MTT) assay. Hypoxia-induced products (IL-1beta, TGF-beta1, IFN-gamma, TNF-alpha, IL-10, IL-6, IL-8, MCP-1 and VEGF) were assessed by enzyme-linked immunosorbent assay. Endothelial permeability was evaluated by Western blotting. RESULTS: Prolonged hypoxia caused endothelial cells to secrete IL-6, IL-8, MCP-1 and VEGF. However, the levels of IL-1, IL-10, TNF-alpha, TGF-beta, IFN-gamma and nitric oxide remained unchanged over 48 h hypoxia. Hypoxic exposure to endothelial cells induced the time-dependent down regulation of the expression of cadherin and catenin protein. The conditioned medium taken from hypoxic HUVECs had the cytotoxic effect selectively on neuroblastoma cells, but not on astroglioma cells. CONCLUSION: These results suggest the possibility that endothelial cell derived cytokines or other secreted products with the increased endothelial permeability might directly contribute to nerve cell injury followed by hypoxia.
Anoxia ; Astrocytoma ; Blotting, Western ; Culture Media, Conditioned ; Cytokines ; Down-Regulation ; Endothelial Cells* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Neuroblastoma ; Neurons* ; Nitric Oxide ; Permeability ; Reperfusion ; Stroke* ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha ; Umbilical Veins ; Vascular Endothelial Growth Factor A

This research was aimed at developing a model for school mental health service. Subjects were students at two elementary schools located in an urban community. The goals of the study included, 1) early detection and intervation in children with mental health problems, 2) developing educational programs for parents and teachers ; 3) developing programs linking mental health resources in the community with the school system(school consultation, telephone counselling, and group activities for high risk-students). Subjects wars 1,732 students at 2 primary schools in a community of Seoul. Problem children were selected through screening with CBCL and were examined by psychiatrists. The results were as follows: 1) Of 1,732 students, nearly 8% had mental health problems. The parents of the students with mental health problems were urged to seek psychiatric care. However, only 8% of them had a positive response. On the other hand, telephone counselling was preferred and 40% of them said they had visited a psychiatric clinic. 2) Regarding the education of parents, they preferred telephone counselling and written information to direct counselling or participating in education programs. In most cases, they avoided talking about their children's problems. 3) Teachers showed a good sense for ducting children's mental health problems, but they suffered from a fueling of helplessness because of lack of knowledge and skills. 4) Special education programs were needed f)r students with serious behavior problems. Group activities, which were directed by college student volunteers, had been proved to be effective in helping children with high risks. 5) This suggests that the stigma for mental disorder is still an obstacle in mental health service and that fechers need on-going systemic education on children's mental health since college period. Based on these study results, the authors suggest a model of school mental health service linking the school system, family(parents) and professional mental health resources in the community.
Child ; Education ; Education, Special ; Hand ; Humans ; Mass Screening ; Mental Disorders ; Mental Health Services* ; Mental Health* ; Parents ; Psychiatry ; Seoul ; Telephone ; Volunteers

A case of traumatic carotid-cavernous fistula treated using Debrun's latex detatchable balloon catheter is reported. The patient was a 33-year-old man, who has complaints of proptosis and chemosis of left eye 2 months after motor vehicle accident. The cerebral angiography showed direct fistula between intracavernous portion of internal carotid artery and cavernous sinus as high flow-high pressure type. After complete radiologic and neurologic examination, the fistulous opening was successfully occluded by Debrun's latex detatchable balloon with transient ischemic attack, was resolved 2 hours after the procedure.
Adult ; Carotid Artery, Internal ; Catheters ; Cavernous Sinus ; Cerebral Angiography ; Exophthalmos ; Fistula ; Humans ; Ischemia ; Ischemic Attack, Transient ; Latex* ; Motor Vehicles ; Neurologic Examination

BACKGROUND AND OBJECTIVES: Aberrant activation of hepatocyte growth factor (HGF) and its receptor, c-Met, has been known to be involved in many human cancer development and progression. During the search for an effective molecule inhibitor of HGF/ c-Met signaling, we have found that Epigallocatechin-3-gallate (EGCG) in green tea might inhibit HGF/c-Met signaling. Studies were performed to address whether EGCG inhibited HGF-dependent tumor proliferation and invasion in HNSCC. MATERIALS AND METHOD: For EGCG inhibition of HGF/c-Met signaling, Western blot was performed. The proliferation of FaDu cells was assayed by counting the number of the cells after treatment by HGF 0, 10 ng/ml, EGCG 1 micrometer, EGCG 10 micrometer, HGF 10+EGCG 1 micrometer, HGF 10+EGCG 10 micrometer. The dispersion of cells was observed by measuring the separation and morphologic changes of the cells after treatment with HGF 0, 10 ng/ml HGF 10+EGCG 1 micrometer, HGF 10+EGCG 10 micrometer for 24 hours. Tumor cell migration was assessed by wound healing assay and tumor cell invasiveness was assessed by the membrane invasion assay. RESULTS: HGF treatment induced rapid activation of c-Met and EGCG inhibited HGF-induced c-Met signaling in FaDu cells. HGF significantly enhanced the growth of HNSCC cells and this phenomenon was inhibited by EGCG in a dose-dependant manner (p<0.05). EGCG inhibited HGF-induced scattering, migration, and invasion of HNSCC cells in a dose-dependent manner (p<0.05). CONCLUSION: Inhibition of HGF/Met by EGCG leads to decreased proliferation, scattering, migration and invasion in vitro, suggesting the possible use of EGCG in HNSCC associated with down-regulation of HGF/Met signaling.
Blotting, Western ; Catechin ; Cell Movement ; Down-Regulation ; Hepatocyte Growth Factor ; Humans ; Hypopharyngeal Neoplasms ; Membranes ; Tea ; Wound Healing

Breast metastases from an extramammary primary tumor are very rare and the prognosis for such patients is generally poor. We report here on a case of a 42-year-old female with metastasis of non-small cell lung cancer to the breast, and she is now being followed up on an outpatient basis. In 2004, she presented with a solitary pulmonary nodule in the left lung, and this lesion had been noted to have gradually increased in size over time. The final pathological diagnosis was adenocarcinoma, and the diagnosis was made by performing percutaneous needle aspiration and lobectomy of the left upper lobe. Adjuvant chemotherapy and radiotherapy were given. Unfortunately, a nodule in the left breast was noted three years later, and metastatic non-small-cell lung cancer to the breast was diagnosed by excisional biopsy. Making the correct diagnosis to distinguish a primary breast carcinoma from a metastatic one is important, because the therapeutic plan and outcome for these two types of cancer are quite different.
Adenocarcinoma ; Adult ; Biopsy ; Breast ; Carcinoma, Non-Small-Cell Lung ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung ; Lung Neoplasms ; Needles ; Neoplasm Metastasis ; Outpatients ; Prognosis ; Solitary Pulmonary Nodule

Background: A healthcare system’s collapse due to a pandemic, such as the coronavirus disease 2019 (COVID-19), can expose healthcare workers (HCWs) to various mental health problems. This study aimed to investigate the impact of the COVID-19 pandemic on the depression and anxiety of HCWs. Methods: A nationwide questionnaire-based survey was conducted on HCWs who worked in healthcare facilities and public health centers in Korea in December 2020. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure depression and anxiety. To investigate factors associated with depression and anxiety, stepwise multiple logistic regression analysis was performed. Results: A total of 1,425 participating HCWs were included. The mean depression score (PHQ-9) of HCWs before and after COVID-19 increased from 2.37 to 5.39, and the mean anxiety score (GAD-7) increased from 1.41 to 3.41. The proportion of HCWs with moderate to severe depression (PHQ-9 ≥ 10) increased from 3.8% before COVID-19 to 19.5% after COVID-19, whereas that of HCWs with moderate to severe anxiety (GAD-7 ≥ 10) increased from 2.0% to 10.1%. In our study, insomnia, chronic fatigue symptoms and physical symptoms after COVID-19, anxiety score (GAD-7) after COVID-19, living alone, and exhaustion were positively correlated with depression. Furthermore, post-traumatic stress symptoms, stress score (Global Assessment of Recent Stress), depression score (PHQ-9) after COVID-19, and exhaustion were positively correlated with anxiety. Conclusion In Korea, during the COVID-19 pandemic, HCWs commonly suffered from mental health problems, including depression and anxiety. Regularly checking the physical and mental health problems of HCWs during the COVID-19 pandemic is crucial, and social support and strategy are needed to reduce the heavy workload and psychological distress of HCWs.