Transforming growth factor beta(TGF-p), initially identified in vlatelet extracts by virtue of its ability to confer anchorage of independent growth and a necplastic phenotype on mesenchymal cells, has subsequently been identified as a potent inh bit or of proliferation in most cells of epithelial origin. The family of TGF-p peptides is currenly onsisted of four subtypes (TGF-pl, p2, p3, p4). Tkiey are initially translated very larged are urssors of approximately 390 amino acids and produced by a wide variety of cell type. iricluding normal cells and tumor cells. TGF-ps promote deposition of extracellular matrix compcineits, facilitate remodeling events during embryonic development, and suppress immune ce 1 fimetion during the inflammatory process. Several nutaneous diseases are characterized typxcessive and progressive fibrosis of the dermis anil subcutaneous tissues. Prominent amon these disorders are progressive systemic sclerosi(PSS) and generalized morphea(GM), is well as the recently described syndrome of diffuse fasciitis eosinophilia(DF), also known; Shulmans syndrome. The hallmark of the pathologic alteration in these disorders is the excessive deposition of collagen and other connenctive iissues. Macromoleculse in the aerriis and/or the subcutaneous and fascial strutures often accompanied by variable degress of hronic inflammatory cell infiltrates. Now we have examined the expression of TGF-b1 mRNA using of northern blot hybridization with specific sequenced cDNA probe in the normal curltured fibroblasts, placental tissues, and fibrosarcorna derived tumor cell line(HT1080). We found that the size of TGF-b mRNA of each specimen was 2.5kb and theres no alteration of its quality.
Amino Acids ; Blotting, Northern ; Collagen ; Dermis ; DNA, Complementary ; Embryonic Development ; Extracellular Matrix ; Fasciitis ; Female ; Fibroblasts* ; Fibrosis ; Humans ; Peptides ; Phenotype ; Pregnancy ; RNA, Messenger* ; Subcutaneous Tissue ; Transforming Growth Factor beta* ; Transforming Growth Factors ; Virtues

A 19-month old male patient developed mutiple, firm, plum-colored, finger tip to chestnut sized nodules on the left cheek, right preauricular area, both elbow joints, and right wrist. On physical examination, a right cervical lymph node was palpable. Histology from one of the nodules revealed a diffuse infiltration of atypical, hyperchromatic, polymorphous lymphocytes in the dermis and subrutaneous fat. Bone marow aspiration, chest X-ray, ultrasonogram, and computerized tomogram were performed revealing bone marrow and lymph node involvement. The patient was treated with a POG @8617 schedule. Skin lesions markedly improved after one cycle regimen. We present a case of diffuse, ponrly differentiated, malignant lymphocytic lymphoma in the early childhood.
Appointments and Schedules ; Bone Marrow ; Cheek ; Dermis ; Elbow Joint ; Fingers ; Humans ; Infant ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymph Nodes ; Lymphocytes ; Lymphoma* ; Male ; Physical Examination ; Skin ; Thorax ; Ultrasonography ; Wrist ; Prunus domestica

BACKGROUND: Epidermolysis bullosa is a group of inherited disorcier characterized by blistering of the skin as a result of minor trauma. OBJECTIVE: There exist very little epidemiologic data for most of the major and minor subsets of inherited epidermolysis bullosa in Korea. We look forward to obtaining basic data for the pathogenesis and treatment of epidermolysis bullosa. METHOD: We performed 1st and 2nd trial of survey with the help of 28 dermatologic Departments snd 28 pediatric departments of medical colleges and 14 dermatologic dipartments of general hospitals. RESULTS: 68 cases were collected and classified by disease type, sex distribution, age distribution, and regional distribution. In disease type, 42 cases of EB simplex(62%), 8 cases of junctional type(12%), 10 cases of dominant dystrophic type(15%), 8 cases of recessive dytrcphic type(12%) were reported. In most cases males predominnted, but in dominant dystrophic type both sexes were equivalent. EB simplex, junctional type, RDEB were mostly developed in the 1st decade of life, dominant dystrophic type in the 2nd decade of life. In regional distribution, the number of pi tients was outstanding in large cities such as Seoul, Pusan, Taegu, Kwanju. CONCLUSION: Due to many limitations and shortage of techniques, this epidemiologic study may be notgood enough for the total estimated number of epidermolysis bullos. patients, prevalence rate, and therapeutic modalities. Furthe evaluation should be necessary next time.
Age Distribution ; Blister ; Busan ; Daegu ; Epidemiologic Studies* ; Epidermolysis Bullosa* ; Gwangju ; Hospitals, General ; Humans ; Korea* ; Male ; Prevalence ; Seoul ; Sex Distribution ; Skin

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is expected to provide fast and comfortable recovery, plus an early return to normal daily activities. This study was carried out to compare the characteristics of recovery after VATS in patients anesthetized with isoflurane, enflurane or propofol. METHODS: Sixty patients undergoing VATS were allocated randomly to receive propofol-N2O, isoflurane-N2O or enflurane-N2O anesthesia. The time between the end of anesthesia and extubation were compared. The orientation, cooperation and degree of sedation in Numeric Rating Scale (NRS) were recorded 5, 10, 30 and 60 min after anesthesia. Recovery was also evaluated by the P-deletion test (PDT) and Digit Symbol Substitution test (DSST) 30, 60 and 120 min after anesthesia for the comparison of the recovery of cognitive and psychomotor function. RESULTS: Early recovery was significantly (P < 0.05) faster in the propofol group (orientation, cooperation and degree of sedation in 10 min) when compared to the isoflurane and enflurane groups, but there was no significant difference in the other parameters of recovery. CONCLUSIONS: The authors concluded that although propofol was associated with faster emergence from anesthesia than enflurane and isoflurane after VATS, recovery of cognitive and psychomotor function were similar in the three anesthetic groups.
Ambulatory Surgical Procedures* ; Anesthesia* ; Enflurane* ; Humans ; Isoflurane* ; Propofol* ; Thoracic Surgery, Video-Assisted

BACKGROUND: The advantages of epidural anesthesia for Caesarean section are well documented. However, its disadvantages include a slow onset time, which preclude its use for urgent procedures. The object of this clinical trial was to ascertain if a useful reduction in onset time may be obtained by fentanyl supplementation versus plain ropivacaine. METHODS: Twenty healthy women scheduled for Caesarean section were allocated randomly to receive 20 ml of 0.75% ropivacaine with normal saline 1 ml (group 1) or 20 ml of 0.75% ropivacaine with fentanyl 50 mcg (group 2) via a epidural catheter inserted 3 cm into the epidural space, identified by the loss of resistance technique using a midline approach at the L3-4 interspace. After insertion of the catheter, and with the patient supine, a test dose of 3 ml of the solution was given, and then the remainder was injected at a rate of 10 ml/min. The time for sensory block to develop at T8 by loss of cold discrimination using an alcohol sponge was defined as the onset time. Onset of block was timed from the end of the last injection. If a sensory block of T6 or higher was not present at 30 min, 5 ml of 2% lidocaine mixed with 0.5 ml of 8.4% sodium bicarbonate were administered until an adequate height of block had been achieved. After surgery had started and discomfort was felt, 50 mcg of i.v. fentanyl was administered repeatedly after delivery. Side effects (hypotension, nausea/vomiting, shivering, bradycardia, respiratory depression) during surgery were recorded, and the upper limit of sensory analgesia to the alcohol sponge was determined. RESULTS: The onset time was 8.7 +/- 4.3 min in group 1 and 11.9 +/- 5.4 min in group 2, respectively. No significant difference was evident between the two groups in terms of onset time to the sensory block to T8. The number of patients that required supplementary analgesia and experiencing side effects was similar. The maximum upper level observed in any patient was C6 in group 1 and C4 in group 2. CONCLUSIONS: The combined use of ropivacaine and fentanyl did not reduce sensory onset or produce an unnecessarily extended sensory block level.
Analgesia ; Anesthesia, Epidural* ; Bradycardia ; Catheters ; Cesarean Section* ; Discrimination (Psychology) ; Epidural Space ; Female ; Fentanyl ; Humans ; Lidocaine ; Porifera ; Pregnancy ; Shivering ; Sodium Bicarbonate

BACKGROUND: Hypoxic pulmonary vasoconstriction (HPV) is unique to pulmonary circulation but the mechanism remains elusive. Red blood cells (RBCs) are known to augment HPV and to release more ATP as oxygen content falls. Leukotrienes constrict smooth muscle and could be important for the regulation of the pulmonary circulation. Hence we hypothesized that ATP and leukotrienes are mediators of HPV produced during acute alveolar hypoxia. METHODS: In forty Sprague-Dawley rats, lungs were isolated and perfused. We administered ATP (10 micrometer) to the ATP group (n = 8), the ATP antagonist, suramin (100 micrometer) to the suramin group (n = 8), leukotriene C4 (LTC4, 5 microgram) to the LTC4 group (n = 8), the LTC4 antagonist, LY171883 (20 micrometer) to the LY171883 group (n = 8), and LTC4 (5 microgram) + ATP (10 micrometer) to the LTC4 + ATP group (n = 8) during normoxic ventilation. HPV responses were induced by three hypoxic challenges for 5 minutes separated by 5 minutes of ventilation with a normoxic gas mixture. Baseline pulmonary artery pressure change after exposure to each drug and hypoxic pressor response between a period 21% normoxic gas ventilation and that of 3% hypoxic gas ventilation were measured. RESULTS: ATP and LTC4 + ATP increased baseline pulmonary artery pressures but LTC4 did not alter it. ATP did not affect hypoxic pressor response. Suramin, LY171883 and LTC4 + ATP inhibited the pressor response to hypoxia. LTC4 increased hypoxic pressor response. CONCLUSIONS: In isolated rat lungs, HPV may be mediated by ATP and LTC4 appears more likely to be a modulator than a mediator of HPV.
Acetophenones ; Adenosine Triphosphate ; Animals ; Anoxia ; Erythrocytes ; Leukotriene C4 ; Leukotrienes ; Lung ; Muscle, Smooth ; Oxygen ; Pulmonary Artery ; Pulmonary Circulation ; Rats ; Rats, Sprague-Dawley ; Suramin ; Tetrazoles ; Vasoconstriction ; Ventilation

BACKGROUND AND OBJECTIVES: The number of permanent pacemakers (PPMs) implanted in patients in Japan and Korea differs significantly. We aimed to investigate the differences in decision making processes of implanting a PPM. MATERIALS AND METHODS: Our survey included 15 clinical case scenarios based on the 2008 AHA/ACC/HRS guidelines for device-based therapy of cardiac rhythm abnormalities (class unspecified). Members of the Korean and Japanese Societies of Cardiology were asked to rate each scenario according to a 5-point scale and to indicate their decisions for or against implantation. RESULTS: Eighty-nine Korean physicians and 192 Japanese physicians replied to the questionnaire. For the case scenarios in which there was a class I indication for PPM implantation, the decision to implant a PPM did not differ significantly between the two physician groups. However, the Japanese physicians were significantly more likely than the Korean physicians to choose implantation in class IIa scenarios (48% vs. 37%, p<0.001), class IIb scenarios (40% vs. 19%, p<0.001), and class III scenarios (36% vs. 18%, p<0.001). These results did not change when the cases were categorized based on disease entity, such as sinus node dysfunction and conduction abnormality. CONCLUSION: Korean physicians are less likely than Japanese physicians to favor a PPM implantation when considering a variety of clinical case scenarios, which probably contributes to the relatively small number of PPMs implanted in patients in Korea as compared with those in Japan.
Asian Continental Ancestry Group ; Atrioventricular Block ; Cardiology ; Decision Making* ; Humans ; Japan* ; Korea* ; Pacemaker, Artificial ; Sick Sinus Syndrome

Imatinib mesylate (Gleevec(R), formerly known as STI571) is a protein-tyrosine kinase inhibitor that inhibits the bcr-abl tyrosine kinase created by the Philadelphia chromosome abnormality in patients with chronic myeloid leukemia (CML). Between 7 to 21% of the patients treated with imatinib mesylate have been reported to develop adverse cutaneous reactions. However, exfoliative dermatitis related to imatinib mesylate is rare and there is only one previously reported case of this in the Korean literature. We report here on a woman with localized exfoliative dermatitis that developed after administering imatinib mesylate for treating her CML.
Benzamides ; Dermatitis, Exfoliative ; Drug Eruptions ; Female ; Fusion Proteins, bcr-abl ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mesylates ; Philadelphia Chromosome ; Piperazines ; Protein-Tyrosine Kinases ; Pyrimidines ; Imatinib Mesylate

Head and neck dermatitis is a variant of atopic dermatitis often seen in young adults. Pityrosporum is a normal skin commensal. Thus, its importance as a pathogen of atopic dermatitis was neglected in the past. It was found, however, that the treatment of head and neck dermatitis with an antifungal agent results in clinical improvement. At present, although the pathogenesis of atopic dermatitis has not yet been fully elucidated, Pityrosporum is considered one of the triggers of head and neck dermatitis. The case of an 18-year-old male who had a history of head and neck atopic dermatitis with erythematous xerotic patches accompanied by a yellowish colored crust and oozing on the facial area is reported herein. The lesion was treated with itraconazole monotherapy for four weeks, after which its condition improved.
Adolescent ; Dermatitis ; Dermatitis, Atopic ; Head ; Humans ; Itraconazole ; Malassezia ; Male ; Neck ; Skin ; Young Adult

BACKGROUND: Protein kinase C represents an important component of a signal transduction pathway that regulates vascular smooth muscle contraction. This study was performed with an inhibitor and activators of protein kinase C to determine their effects on hypoxic pulmonary vasoconstriction (HPV) in isolated rat lung model. METHODS: Isolated lungs from Sprague-Dawley rats were ventilated with a normoxic gas (21%O2-5%CO2-balanced N2) and a hypoxic gas (3%O2-5%CO2-balanced N2) alternatively, and then perfused with constant pulmonary blood flow. Baseline hypoxic pressor responses (delta PAP) were measured as the difference of pulmonary artery pressure between normoxic ventilation and hypoxic ventilation. After baseline delta PAP had obtained, rats were randomly divided into a chelerythrine group, an phorbol 12, 13-dibutyrate (PDBu) group, and a farnesylthiotriazole (FTT) group. The different concentrations of each drug were added into the perfusate sequentially. delta PAP in the different concentrations of each drug were calculated as a percentage of the delta PAP in each concentration of drug to the baseline delta PAP in the absence of drug (%delta PAP). RESULTS: The %delta PAP of chelerythrine were 83.7 +/- 19.2%, 71.5 +/- 24.1% and 68.4 +/- 28.3% at 0.1, 1, and 10micrometer, respectively (P < 0.05). The %delta PAP of PDBu were 111.3 +/- 10.1%, 144.4 +/- 37.8% and 168.4 +/- 89.1% at 20, 100, and 300 nM, respectively (P < 0.05). The %delta PAP of FTT were 80.1 +/- 25.1%, 61.0 +/- 17.2% and 30.1 +/- 18.4% at 1, 10, and 30micrometer, respectively (P < 0.05). CONCLUSIONS: The results of this study suggest that regulator of protein kinase C influence HPV.
Animals ; Lung* ; Muscle, Smooth, Vascular ; Protein Kinase C* ; Protein Kinases* ; Pulmonary Artery ; Rats* ; Rats, Sprague-Dawley ; Signal Transduction ; Vasoconstriction* ; Ventilation