Sinusoidal hemangioma is a rare variant of cavernous hemangioma. Clinically, it develops in adults and predominantly in females, and presents as a solitary painless subcutaneous nodule. Histological finding of the sinusoidal hemangioma shows a well-circumscribed lobular architecture in the subcutaneous tissue. The lobulated mass is composed of dilated sinusoidal thin-walled vascular channels, which have a pseudopapillary pattern and back-to-back arrangement without much intervening stroma. We report a case of sinusoidal hemangioma which can be differentiated from the other vascular tumors and has never been reported in Korea.
Adult ; Female ; Hemangioma* ; Hemangioma, Cavernous ; Humans ; Korea ; Subcutaneous Tissue

BACKGROUND: To ensure the safety of plasma derivatives, some countries have been screening for the human parvovirus B19 (B19V) antigen or DNA in blood donors. We investigated the prevalence of B19V DNA and anti-B19V antibodies in Korean plasmapheresis donors to evaluate the necessity of B19V DNA screening test. METHODS: Plasma samples were collected between March and July 2008 from 10,032 plasmapheresis donors. The B19V DNA test was performed using the LightCycler 2.0 (Roche, Germany) with quantification kits. Anti-B19V IgM and IgG were tested in 928 randomly selected samples from the 10,032 donors using recomWell Parvovirus B19 ELISA IgM, IgG assay (Mikrogen, Germany). RecomLine Parvovirus B19 LIA IgG, IgM assay (Mikrogen, Germany) was used to analyze the epitopes of antibodies in donors showing positive results for B19V DNA and anti-B19V antibodies. DNA sequencing was performed to identify the genotypes. RESULTS: The prevalence of B19V DNA was 0.1% (10/10,032). Virus titers in B19V DNA positive donors were less than 10(5) IU/mL (range: 2.7x10(1)-3.2x10(4) IU/mL) except for 1 donor (1.33x10(8) IU/mL). All the isolated B19V DNAs from 6 donors were identified as genotype I. Nine out of 10 B19V DNA positive donors also possessed anti-B19V IgG only or IgG and IgM. The prevalence of anti-B19V IgG was 60.1% (558/928). CONCLUSIONS: The prevalence of B19V DNA in Korean blood donors was not high and most donors also possessed neutralizing anti-B19V antibodies. Thus, the implementation of a B19V screening test for Korean blood donors does not appear to be imperative.
Adolescent ; Adult ; Aged ; Antibodies, Viral/blood ; *Blood Donors ; DNA, Viral/*blood ; Enzyme-Linked Immunosorbent Assay/methods ; Female ; Follow-Up Studies ; Genotype ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Male ; Middle Aged ; Parvoviridae Infections/epidemiology ; Parvovirus B19, Human/genetics/immunology/*isolation & purification ; *Plasmapheresis ; Polymerase Chain Reaction/methods ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies

BACKGROUND: The safety of plasma derivatives has been reinforced since 1980s by variable pathogen inactivation or elimination techniques. Nucleic acid amplification test (NAT) for the source plasma has also been implemented worldwide. Recently nanofiltration has been used in some country for ensuring safety of plasma derivatives to eliminate non-enveloped viruses such as parvovirus B19 (B19V) and hepatitis A virus (HAV). We evaluated the efficacy of nanofiltration for the elimination of B19V and HAV. METHODS: To verify the efficacy of nanofiltration, we adopted a 20 nm Viresolve NFP (Millipore, USA) in the scaling down (1:1,370) model of the antithrombin III production. As virus stock solutions, we used B19V reactive plasma and porcine parvovirus (PPV) and HAV obtained from cell culture. And 50% tissue culture infectious dose was consumed as infectious dose. The methods used to evaluate the virus-elimination efficacy were reverse-transcriptase polymerase chain reaction for B19V and the cytopathic effect calculation after filtration for PPV and HAV. RESULTS: B19V was not detected by RT-PCR in the filtered antithrombin III solutions with initial viral load of 6.42x10(5) IU/mL and 1.42x10(5) IU/mL before filtration. The virus-elimination efficacy of nanofiltration for PPV and HAV were > or =10(3.32) and > or =10(3.31), respectively. CONCLUSIONS: Nanofiltration would be an effective method for the elimination of B19V and HAV. It may be used as a substitute for NAT screening of these viruses in source plasma to ensure safety of plasma derivatives in Korea.
Antithrombin III/isolation & purification ; DNA, Viral/analysis ; Filtration/*methods ; Hepatitis A virus/genetics/*isolation & purification ; Humans ; Nanotechnology/*methods ; Parvovirus B19, Human/genetics/*isolation & purification ; RNA, Viral/analysis ; Reverse Transcriptase Polymerase Chain Reaction

Glucagon-like peptide-1 (GLP-1) receptor agonists have been used extensively in the clinic and have an established safety profile in cardiovascular disease settings. For the treatment of peptide-secreting enteroendocrine cells, most research has focused on developing peptide multi-agonists as most of these cells are multihormonal. Among the various peptides secreted by enteroendocrine cells, the combination of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) is an attractive strategy for treating type 2 diabetes mellitus (T2DM) because both of these hormones have glucose-lowering actions. Tirzepatide, a synthetic peptide composed of 39 amino acids, functions as a dual receptor agonist of both the GIP and GLP-1 receptors. This unique mechanism of action has earned tirzepatide the nickname “twincretin.”Tirzepatide’s dual agonist activity may be the mechanism by which tirzepatide significantly reduces glycated hemoglobin levels and body weight in patients with T2DM as observed in phase 3 clinical trials. Besides its glucose-lowering and anti-obesity effects, tirzepatide has been reported to have potential cardiovascular benefits. In this review, we discuss the cardiovascular effects of tirzepatide based on the available preclinical and clinical data.

PURPOSE: Multidrug resistance (MDR) of the cancer cells related to mdr1 gene expression can be effectively treated by selective short hairpin RNA for mdr1 gene (shMDR). Sodium/iodide symporter (NIS) gene is well known to have both reporter and therapeutic gene characteristics. We have co-transfected both shMDR and NIS gene into colon cancer cells (HCT15 cell) expressing MDR and Tc-99m sestamibi and I-125 uptake were measured. In addition, cytotoxic effects of doxorubicin and I-131 therapy were also assessed after transfection. MATERIAL AND METHODS: At first, shMDR was transfected with liposome reagent into human embryonic kidney cells (HEK293) and HCT cells. shMDR transfection was confirmed by RT-PCR and western blot analysis. Adenovirus expressing NIS (Ad-NIS) gene and shMDR (Ad-shMDR) were co-transfected with Ad-NIS into HCT15 cells. Forty-eight hours after infection, inhibition of P-gycoprotein (Pgp) function by shMDR was analyzed by a change of Tc-99m sestamibi uptake and doxorubicin cytotoxicity, and functional activity of induced NIS gene expression was assessed with I-125 uptake assay. RESULTS: In HEK293 cells transfected with shMDR, mdr1 mRNA and Pgp protein expressions were down regulated. HCT15 cells infected with 20 MOI of Ad-NIS was higher NIS protein expression than control cells. After transfection of 300 MOI of Ad-shMDR either with or without 10 MOI of Ad-NIS, uptake of Tc-99m sestamibi increased up to 1.5-fold than control cells. HCT15 cells infected with 10 MOI of Ad-NIS showed approximately 25-fold higher I-125 uptake than control cells. Cotransfection of Ad-shMDR and Ad-NIS resulted in enhanced cytotoxic by doxorubicin in HCT15 cells. I-131 treatment on HCT15 cells infected with 20 MOI of Ad-NIS revealed increased cytotoxic effect. CONCLUSION: Suppression of mdr1 gene expression, retention of Tc-99m sestamibi, enhanced doxorubicin cytotoxicity and increases in I-125 uptake were achieved in MDR expressing cancer cell by co-transfection of shMDR and NIS gene. Dual therapy with doxorubicin and radioiodine after cotransfection shMDR and NIS gene can be used to overcome MDR.
Adenoviridae ; Blotting, Western ; Colonic Neoplasms ; Doxorubicin* ; Drug Resistance, Multiple* ; Gene Expression ; HEK293 Cells ; Humans ; Ion Transport* ; Kidney ; Liposomes ; RNA, Messenger ; RNA, Small Interfering ; Transfection

Relapsing polychondritis is a systemic disorder characterized by recurrent inflammation and degeneration of cartilaginous tissue throughout the body. The association with HLA-DR4 and the occurrence of antibodies to type II collagen and other antoantibodies suggest that an immunologic mechanism is involved in its pathogenesis. The eyes, oars, nose, larynx, trachea and articular areas are commonly involved. Airway narrowing or collapse from respiratory tract involvement, occurs in up It 50% of patients with relapsing polychondritis. Treatment consists of administration of corticosteroids arid other anti-inflammatory and immunosuppresive drugs. We experienced a case of relapsing polychondritis involving the tracheobronchial tree, nose and ears in a 49-year-old woman. The patient was clinically and histologically diagnosed as relapsing polychondritis according to McAdam's and Damiani's criteria. We report this case with a review of the literature.
Adrenal Cortex Hormones ; Antibodies ; Collagen Type II ; Ear ; Female ; HLA-DR4 Antigen ; Humans ; Inflammation ; Larynx ; Middle Aged ; Nose ; Polychondritis, Relapsing* ; Respiratory System ; Trachea

PURPOSE: Inhaled corticosteroids (ICS) are used as first-line agents for the treatment of persistent asthma; however, their use is accompanied by apprehension of potential systemic adverse effects. This study aimed to assess the effects of ICS on bone mineral density (BMD) and bone metabolism in children with asthma. METHODS: From February 2008 to September 2008, 26 asthmatic children treated with ICS (ICS group), 15 asthmatic children treated with leukotriene receptor antagonist (LTRA) (LTRA group), and 30 healthy children (Control group) were selected from the Korea University Anam Hospital. BMD and serum bone-specific alkaline phosphatase (BALP) levels were measured. The asthmatic children underwent spirometry and methacholine bronchial challenge test. RESULTS: There were no significant differences in BMD in the lumbar spine (P=0.254) and proximal femur (P=0.297) among the 3 groups. The serum BALP levels were significantly higher in both the ICS (P=0.017) and LTRA (P=0.025) groups than in the Control group. None of the parameters pertaining to ICS use, such as the mean daily dose during the last 6 months, the total cumulative dose, duration of use, and age of commencement of use, showed significant correlations with BMD (P>0.05 for all parameters). CONCLUSIONS: We demonstrated that a low dose of ICS does not exert any significant adverse effect on bone metabolism in asthmatic children. These findings support the current recommendations with regard to the use of ICS for asthmatic children.
Adrenal Cortex Hormones ; Alkaline Phosphatase ; Asthma ; Bone Density ; Bronchial Provocation Tests ; Child ; Femur ; Humans ; Korea ; Methacholine Chloride ; Receptors, Leukotriene ; Spine ; Spirometry

PURPOSE: This study was conducted to investigate the immune responses of children with moderate and severe novel influenza A virus (H1N1) pneumonia, and to compare their clinical and immunological findings with those of control subjects. METHODS: Thirty-two admitted patients with H1N1 pneumonia were enrolled in the study. The clinical profiles, humoral and cell-mediated immune responses of the 16 H1N1 pneumonia patients who were admitted to the pediatric intensive care unit (severe pneumonia group), 16 H1N1 pneumonia patients admitted to the pediatric general ward (moderate pneumonia group) and 13 control subjects (control group) were measured. RESULTS: Total lymphocyte counts were significantly lower in patients with H1N1 pneumonia than in the control group (P=0.02). The number of CD4+ T lymphocytes was significantly lower in the severe pneumonia group (411.5+/-253.5/microL) than in the moderate pneumonia (644.9+/-291.1/microL, P=0.04) and control (902.5+/-461.2/microL, P=0.01) groups. However, the number of CD8+ T lymphocytes was significantly higher in the severe pneumonia group (684.2+/-420.8/microL) than in the moderate pneumonia (319.7+/-176.6/microL, P=0.02) and control (407.2+/-309.3/microL, P=0.03) groups. The CD4+/CD8+ T lymphocytes ratio was significantly lower in the severe pneumonia group (0.86+/-0.24) than in the moderate pneumonia (1.57+/-0.41, P=0.01) and control (1.61+/-0.49, P=0.01) groups. The serum levels of IgG, IgM and IgE were significantly higher in the severe pneumonia group than in the 2 other groups. CONCLUSION: The results of this study suggest that increased humoral immune responses and the differences in the CD4+ and CD8+ T lymphocyte profiles, and imbalance of their ratios may be related to the severity of H1N1 pneumonia in children.
Child ; Humans ; Immunity, Humoral ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Influenza A virus ; Influenza, Human ; Intensive Care Units ; Lymphocyte Count ; Lymphocytes ; Pandemics ; Patients' Rooms ; Pneumonia ; T-Lymphocytes

This report dscribes the thymic carcinoid tumor behaved in a highly aggressive fashion metastasis. Anti-cancer chemotherapy was not effective, the patient died of progressive disease after three months of diagnosis.
Bone Marrow* ; Carcinoid Tumor* ; Diagnosis ; Drug Therapy ; Humans ; Neoplasm Metastasis* ; Pleural Effusion ; Thymus Gland

PURPOSE: The education for self-management of asthma is considered as an essential component to control asthma and improve outcomes. This study aimed to develope an educational game for increasing knowledge of asthma management among children and their caregivers. METHODS: Three subspecialists of pediatric allergy and respirology, 1 pediatrician, 3 pediatric residents and 15 medical students conducted this study. An instructional systemic design using analysis, design, development, implementation and evaluation (ADDIE) model was applied in the entire process of game production. We surveyed the demands of asthma education in 19 caregivers of children who were in the treatment of asthma in Korea University Anam Hospital and reflected its results on the construction of game. For the evaluation of the objective effects of developed game, the comparison study was performed between the patients who had experienced the game (n=20) and those who had not (n=22) by using questionnaire about the knowledge of asthma. RESULTS: The game was developed as a form of board game and had contents including precipitating factors, symptoms and treatment of asthma. The patients older than elementary student easily understood the mode and substances of game, and participated with their concentrations throughout approximately 2 hours' operating time. In analysis of the knowledge level of asthma, the patients who had experienced board game showed significantly higher knowledge level than those who had not (74.0+/-17.6 vs. 55.0+/-17.1, P=0.006). CONCLUSION: We developed a family board game for the asthma education through the systematic production process. The board game may increase the knowledge level in asthmatic children, which would improve the ability of self-management.
Asthma ; Caregivers ; Child ; Humans ; Hypersensitivity ; Korea ; Precipitating Factors ; Surveys and Questionnaires ; Self Care ; Students, Medical