BACKGROUND: CD34 is a 115 kD glycoprotein which is expressed on hematopoietic progenitor cells. It is also known as an immunohistochemical marker of endothelial cells. OBJECTIVE: This study was designed to investigate the patterns of CD34 expression on: (1) cutaneous benign and malignant vascular tumors and (2) on the mature and immature vessels of pyogenic grauloma and capillary hemangioma. METHOD: We performed immunoperoxidase staining using a monoclonal anti-CD34 antibody (QBEND/10) on formalin fixed, paraffin-embedded sections of 23 benign and malignant cutaneous vascular tumors. RESULTS: The results are summerized as follows: 1. In 3 cases of nevus flammeus and 6 cases of carvernous hemangioma, vascular endothelial cells of all hemangiomas showed CD34 expressions. In 5 cases of angiokeratoma, endothelial cells of hemangioma, did not express CD34. 2. In all 5 cases of pyogenic granulomas and one case of capillary hemangioma, endothelial cells of mature vessels, endothelial cells near the well-formed lumina and endothelial cells showing intracellular lumina showed strong positivity for CD34, wbile endothelial cells far from the lumina and endothelial cells without lumina formation mostly showed negative staining for CD34. 3. One cese of Kaposis sarcoma showed focall positivity for CD34 both in endothelial cells of the small, well-formed vessels and spindle cells. Two cases of angiosarcoma showed CD34 expression only in endothelial cells of well-formed, normal appearing vessels, whereas atypical endothelial cells of tumor vessels and spindle cells were negative for CD34. CONCLUSION: CD34 could be a marker for endothelium in mature, well-differentiated vascular structures and may serve as a marker of lumen formation or differentiation of endothelial cells.
Angiokeratoma ; Endothelial Cells ; Endothelium ; Formaldehyde ; Glycoproteins ; Granuloma, Pyogenic ; Hemangioma ; Hemangioma, Capillary ; Hemangiosarcoma ; Hematopoietic Stem Cells ; Negative Staining ; Port-Wine Stain ; Sarcoma, Kaposi

Split hand and split foot(SHSF) is a human developmental defect characterized by missing digits, fusion of remaining digits, and a deep median cleft resulting in a clawlike appearance of the hands and feets. SHSF is usually inherited in an autosomer dominant fashion. The incidence of SHSF is between 1/10,000 and 1/90,000. Thirteen cases of SHSF and chromosomal aberrations involving 7q21-22 have been described so far in the world. We experienced a case of typical tetramelic SHSF in neonate. Chromosome studies showed a pericentric inversion of chromosome 7:46,XY,inv(7) (p22q22). Inspection of the extremities and chromosome studies in the parents were normal.
Chromosome Aberrations ; Chromosomes, Human, Pair 7* ; Extremities ; Foot* ; Hand* ; Human Development ; Humans ; Incidence ; Infant, Newborn ; Parents

BACKGROUND: Though infections of Helicobacter pylori (H. pylori) are closely associated with activation of host angiogenesis, the underlying mechanisms, as well as the strategy for its prevention, have not been identified. Here, we investigated a causal role of H. pylori infection in angiogenesis of gastric mucosa and a potent inhibitory effect of a gastric proton pump inhibitor (PPI) on the gastropathy. MATERIALS AND METHODS: A comparative analysis of CD 34 expression in tissues obtained from 20 H. pylori-associated gastritis and 18 H. pylori-negative gastritis patients was performed. Expression of HIF-1alpha and VEGF were tested by using RT-PCR. To evaluate the direct effect of H. pylori infection on differentiation of endothelial HUVEC cells, we carried out an in vitro angiogenesis assay. RESULTS: H. pylori-associated gastritis tissues showed significantly higher density of CD34+ blood vessels than did H. pylori-negative gastritis tissues, and the levels were well correlated with expressions of HIF-1alpha. Conditioned media from H. pylori-infected gastric mucosal cells stimulated a tubular formation of HUVEC cells. We also found a significant inhibitory effect of PPI, an agent frequently used for H. pylori eradication, on H. pylori-induced angiogenesis. This drug effectively inhibited the phosphorylation of MAP kinase ERK1/2, which is a principal signal for H. pylori-induced angiogenesis. CONCLUSION: The fact that PPIs can down-regulate H. pylori-induced angiogenesis suggest that anti-angiogenic treatment using PPI may be a preventive approach for H. pylori-associated carcinogenesis.
Blood Vessels ; Carcinogenesis ; Culture Media, Conditioned ; Gastric Mucosa ; Gastritis ; Helicobacter pylori ; Helicobacter* ; Human Umbilical Vein Endothelial Cells ; Humans ; Phosphorylation ; Phosphotransferases ; Proton Pumps* ; Protons* ; Stomach Neoplasms ; Vascular Endothelial Growth Factor A

For many years, the histogenesis of the granular cell tumor was controversial and this resulted in the tumor being given more than 20 synonyms. Abrikossoff, reporting on the fiist granular cell tomor, favored a muscle origin, but other authora have postulated a fibroblastic or a histiocytic origin. Recently, the concept of Schwann cell origin, supported by electron microscopic studies and immunohistochemistry of S-100 protein, has gained wider recognition. Approximately 90 cases of esophageal granular cell tumor have been reported in the literature, representing about 2% incidence of all reported granular cell tumor, In Korea, only four cases of granular cell tumors were reported in the literatures including the cases occuring in the cecum, colon, and anus until now. Recently we experienced 46-years old women with granular cell tumor of the esophagus, which might be the second case in Korean literature.
Anal Canal ; Cecum ; Colon ; Esophagus* ; Female ; Fibroblasts ; Granular Cell Tumor* ; Humans ; Immunohistochemistry ; Incidence ; Korea ; Middle Aged ; S100 Proteins

Lack of validity and reliability in selection procedure for internship at teaching hospitals has become a nationwide serious issue, especially regarding its influence on undergraduate medical education. This article describes a case model of selection procedure for internship at Seoul National University Hospital aiming for appropriate measurement of clinical competency as well as a meaningful feedback to the undergraduate medical education. The modification of selection was based on two parts; a problem-based written examination and a clinical skill-attitude assessment. For the former, a total of 60 test items for 34 problem cases were developed, being provided with a variety of pictorials and figures to simulate a real clinical setting. The knowledge level of all test items were either interpretation or problem-solving, and multi-answer items were randomly included to minimize a risk of high chance scoring in multiple choice items. The clinical skill was assessed with 10 important skills with predesigned check list. We conclude that problem-oriented written examination together with clinical skill assessment is a way of improving the measurement of clinical competency and strengthens clinical clerkship effectively during the undergraduate clinincal studies.
Clinical Clerkship ; Clinical Competence ; Education* ; Education, Medical, Undergraduate ; Hospitals, Teaching* ; Internship and Residency* ; Reproducibility of Results ; Seoul

BACKGROUND/AIMS: The aim was to compare the insulin sensitivity and secretion index of pregnant Korean women with normal glucose tolerance (NGT), gestational impaired glucose tolerance (GIGT; only one abnormal value according to the Carpenter and Coustan criteria), and gestational diabetes mellitus (GDM). METHODS: A cross-sectional study was performed with 1,163 pregnant women with positive (1-hour plasma glucose > or = 7.2 mmol/L) in a 50-g oral glucose challenge test (OGCT). The 100-g oral glucose tolerance test (OGTT) was used to stratify the participants into three groups: NGT (n = 588), GIGT (n = 294), and GDM (n = 281). RESULTS: The GDM group had higher homeostasis model assessment of insulin resistance and lower insulin sensitivity index (ISOGTT), quantitative insulin sensitivity check index, homeostasis model assessment for estimation of index beta-cell secretion (HOMA-B), first and second phase insulin secretion, and insulin secretion-sensitivity index (ISSI) than the NGT group (p < or = 0.001 for all). Moreover, the GIGT group had lower ISOGTT, HOMA-B, first and second phase insulin secretion, and ISSI than the NGT group (p < 0.001 for all). Among the GIGT subjects, the 1-hour plasma glucose abnormal levels group showed significantly greater weight gain during pregnancy and higher values in the 50-g OGCT than the other two groups. Moreover, the 1-hour and 2-hour abnormal levels groups had poorer insulin secretion status than the 3-hour abnormal levels group. CONCLUSIONS: Korean women with GDM show impairments of both insulin secretion and insulin sensitivity. In addition, GIGT is associated with both beta-cell dysfunction and insulin resistance.
Adult ; Cross-Sectional Studies ; Diabetes, Gestational/*metabolism ; Female ; Glucose Tolerance Test ; Humans ; Insulin/*secretion ; *Insulin Resistance ; Pregnancy

No abstract available.
Animals ; Calcium* ; Dogs* ; Glass*

BACKGROUND: Remnant lipoproteins are the lipolytic degradation product of the triglyceride-rich lipoproteins produced by the liver (very-low-density lipoprotein cholesterol) and intestine (chylomicrons). Recent studies have demonstrated a correlation between remnant lipoproteins and cardiovascular risk. Our study assessed the relationship between obesity and remnant lipoproteins and evaluated the factors related to remnant lipoprotein in children and adolescents. METHODS: Body mass index (BMI), waist circumference, systolic and diastolic blood pressures, body fat mass, total abdominal fat, visceral and subcutaneous fat areas, total cholesterol, triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and remnant lipoprotein cholesterol (RLP-C) were measured in 135 children and adolescents (67 boys and 68 girls). Plasma RLP fractions were isolated using an immunoaffinity gel containing specific anti-apoB-100 and anti-apoA-I antibodies. The subjects were divided into three groups: the low (< 50 percentile), mid (50~84 percentile), and high (> or = 85 percentile) BMI groups. RESULTS: RLP-C was significantly correlated with age, sex, BMI, waist circumference, systolic and diastolic blood pressures, visceral and subcutaneous fat areas, visceral fat area to subcutaneous fat area ratio (VSR), total cholesterol, TG, HDL-C, apoB, and HOMA-IR. From a multivariate regression analysis, TG (beta = 0.928, P < 0.001) was found to be independently correlated with RLP-C. After excluding TG as an independent variable, a multivariate regression analysis revealed that the HOMA-IR (beta=0.231, P=0.007) and systolic blood pressure (beta=0.169, P=0.046) were independently associated with RLP-C. CONCLUSION: RLP-C was significantly higher in obese children and adolescents. TG, systolic blood pressure, and insulin resistance were related to remnant lipoproteins.
Abdominal Fat ; Adipose Tissue ; Adolescent* ; Antibodies ; Apolipoproteins B ; Blood Pressure ; Body Mass Index ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Humans ; Insulin Resistance ; Intestines ; Intra-Abdominal Fat ; Lipoproteins* ; Liver ; Obesity ; Pediatric Obesity* ; Plasma ; Subcutaneous Fat ; Triglycerides ; Waist Circumference

BACKGROUND: Remnant lipoproteins are the lipolytic degradation product of the triglyceride-rich lipoproteins produced by the liver (very-low-density lipoprotein cholesterol) and intestine (chylomicrons). Recent studies have demonstrated a correlation between remnant lipoproteins and cardiovascular risk. Our study assessed the relationship between obesity and remnant lipoproteins and evaluated the factors related to remnant lipoprotein in children and adolescents. METHODS: Body mass index (BMI), waist circumference, systolic and diastolic blood pressures, body fat mass, total abdominal fat, visceral and subcutaneous fat areas, total cholesterol, triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and remnant lipoprotein cholesterol (RLP-C) were measured in 135 children and adolescents (67 boys and 68 girls). Plasma RLP fractions were isolated using an immunoaffinity gel containing specific anti-apoB-100 and anti-apoA-I antibodies. The subjects were divided into three groups: the low (< 50 percentile), mid (50~84 percentile), and high (> or = 85 percentile) BMI groups. RESULTS: RLP-C was significantly correlated with age, sex, BMI, waist circumference, systolic and diastolic blood pressures, visceral and subcutaneous fat areas, visceral fat area to subcutaneous fat area ratio (VSR), total cholesterol, TG, HDL-C, apoB, and HOMA-IR. From a multivariate regression analysis, TG (beta = 0.928, P < 0.001) was found to be independently correlated with RLP-C. After excluding TG as an independent variable, a multivariate regression analysis revealed that the HOMA-IR (beta=0.231, P=0.007) and systolic blood pressure (beta=0.169, P=0.046) were independently associated with RLP-C. CONCLUSION: RLP-C was significantly higher in obese children and adolescents. TG, systolic blood pressure, and insulin resistance were related to remnant lipoproteins.
Abdominal Fat ; Adipose Tissue ; Adolescent* ; Antibodies ; Apolipoproteins B ; Blood Pressure ; Body Mass Index ; Child ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Humans ; Insulin Resistance ; Intestines ; Intra-Abdominal Fat ; Lipoproteins* ; Liver ; Obesity ; Pediatric Obesity* ; Plasma ; Subcutaneous Fat ; Triglycerides ; Waist Circumference

BACKGROUND/AIMS: The extraction of large common bile duct (CBD) stones after an endoscopic sphincterotomy (EST) is successful in 80~90% of cases but it often requires a prolonged time and repeated trials. This study investigated the utility of a combined endoscopic papillary large balloon dilatation (EPLBD) and a mid-incision of an EST (m-EST) method for the removal of large CBD stones. METHODS: Thirty patients with large CBD stones were enrolled in this study. EPLBD was carried out using the one-step inflation of a 15~18 mm diameter balloon after m-EST. RESULTS: The maximum stone diameter was 21.62+/-5.38 mm. Twelve patients had more than 4 stones, 7 patients had 2 stones, and the remainder had a single large stone. Complete ductal clearance was achieved in all patients. After the procedure, the serum amylase and/or lipase levels were elevated in 3 patients (13.3%). However, there was no episode of true pancreatitis. Minor bleeding was encountered in only one patient (3.3%), and was easily controlled by an endoscopic epinephrine injection. The procedure was carried out safely in 6 patients with periampullary diverticulum. No perforation or mortality was encountered. CONCLUSIONS: Combined EPLBD and m-EST is a safe and effective method, and may be a good alternative treatment for removing large CBD stones.
Amylases ; Bile Ducts* ; Bile* ; Choledocholithiasis ; Common Bile Duct ; Dilatation* ; Diverticulum ; Epinephrine ; Hemorrhage ; Humans ; Inflation, Economic ; Lipase ; Mortality ; Pancreatitis ; Sphincterotomy, Endoscopic*