The goals of this research are to improve the functionality (insulin secretion rate and pattern) and to expand the life-span of immunoprotected pancreatic islets. The low functionality (less than 15% of the insulin release rate of native islets in pancreas) required a large number of islets within the implant, which causes complications in surgery and discomfort for patients. The limited life-span of the islets in a biohybrid artificial pancreas (BAP) may require frequent cell reseeding and cause further supply problems in islet transplantation. Improved islet functionality and prolonged life-span will minimize the volume of the BAP by reducing the number of islets needed for diabetic patients to achieve normoglycaemia and reduce problems associated with islet supply. It is hypothesized in this research that 1) by mimicking facilitated oxygen transport in avascular tissues, the immunoprotected islets release a higher amount of insulin, recover their intrinsic biphasic release pattern, and prolong their life-span, and 2) insulinotropic agents further promote insulin secretion from islets. Based on these hypotheses, a new BAP system will be designed which contains the water-soluble polymeric conjugates of oxygen carriers (or oxygen binding vehicles) and islet stimulants of sulfonylurea compounds and glucagon-like insulinotropic peptide-1 with entrapped islets in the BAP. The research examines their effects on islet viability, the amount of insulin secretion, the insulin release profile, and the life-span of immunoprotected pancreatic islets. Especially, the combined synergy effects of both hypotheses will be emphasized. The successful results in improving functionality and life- span of islets entrapped in an immunoprotected membrane can be applied in the delivery of microencapsulated therapeutic cells and to the miniaturization of a BAP. In addition, the approaches proposed in this research will provide a potential solution to the shortage problem of human cell or tissue sources.
Diabetes Mellitus, Type 1/*surgery ; Diffusion Chambers, Culture ; Humans ; Islets of Langerhans ; *Pancreas, Artificial

Down syndrome is the most common autosomal syndrome in man. The incidence of trisomy 21 due to translocation is about 3.5-5%. Translocations are usually centric fusions between a 21 and a D group (54.2%) or a G group (40.9%) chromosome. Since the short arm of 21 carries no phenotypically active genes, even if the short arm of 21 is lost, usually there is no imbalance with clinical significance. Rare translocations in Down syndrome may also occur between a 21 and other chromosomes (4.9%). We experienced a case of unusual (1q;21q) translocation Down syndrome inherited from a t (1q;21q) balanced carrier mother. The segmental trisomy was confirmed by FISH analysis. This is the first case of a familial Down syndrome with t (1q;21q) in Korea.
Arm ; Down Syndrome* ; Humans ; Incidence ; Korea ; Mothers* ; Trisomy

BACKGROUND: The simple renal cyst is the most prevalent cystic deformation in adults and is most of them are incidentally found during medical examination. In this study, the clinical differences were compared between simple renal cyst and control groups diagnosed by abdominal ultrasonography during periodic medical examination. METHODS: We randomly selected 2,277 persons who took medical examination in one general hospital health promotion center. Among them, analysis was conducted for 188 subjects with simple renal cyst and 188 subjects without renal cyst whose sex, age, and body mass index were matched. Renal cyst subjects were compared with control group to search for their relationship with hypertension, renal function and microscopic hematuria, past medical history, social history, results of other abdominal ultrasonography findings, urine test, and blood test. RESULTS: Among 2,213 subjects, simple renal cyst was found in 188 subjects (8.5%). The subjects who had more than three simple renal cysts were significant older (P = 0.05) and the oldest age was 70's. Also, higher hypertension prevalence (P = 0.05), more microscopic hematuria, higher serum creatinine (P = 0.02), and lower glomerular filtration rate (P < 0.01) were observed in simple renal cyst group. CONCLUSION: It is needed to survey size, shape and change of simple renal cyst using abdominal ultrasonography as well as how its progression may be related to developing hypertension, decreased renal function and microscopic hematuria.
Adult ; Body Mass Index ; Creatinine ; Glomerular Filtration Rate ; Health Promotion ; Hematuria ; Hospitals, General ; Humans ; Hypertension ; Hypertension, Renal ; Prevalence

BACKGROUND: A number of skin manifestations in patients with allergic contact dermatitis result from sensitization with specific allergens. The patch test is a primary diagnostic tool for identifying allergens causing allergic contact dermatitis. OBJECTIVE: We identified the results of patch test with Korean standard series in patients with clinically diagnosed with contact dermatitis, and evaluated the specific relationship with each allergen. METHODS: During a 5-year period, 743 patients were examined with patch test of standard Korean series. The results of patch test were then evaluated. Location of the skin lesion, age, sex, and occupation of the patients were completely reviewed. RESULTS: Overall, 68.5% of patients had at least one positive reaction and 43.6% of patients had two or more positive reactions. Allergens most frequently causing positive reactions were nickel sulfate (27.1%), cobalt chloride (22.1%), potassium dichromate (17.9%), mercuric ammonium chloride (13.8%), and 4-phenyledediamine base (10.2%). Those patients in their 10s and 40s showed the highest rate of positive reaction. Metal allergens displayed higher positive rates than any other standard allergens. Of 201 patients who showed positive reaction to nickel, 37.8% and 27.3% of them also showed positive reaction to cobalt and chromium, respectively, representing concomitant reactions between metal-related antigens. In addition, polysensitization to cosmetics-related antigens including balsam peru and fragnance mix was evident. CONCLUSION: There was no significant difference in overall positive rate in patch test results compared with recent studies. However, we confirmed that metal-related allergens remain most common, and that multiple contact allergy were relatively common.
Allergens ; Ammonia ; Ammonium Chloride ; Chromium ; Cobalt ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Humans ; Hypersensitivity ; Mercuric Chloride ; Nickel ; Occupations ; Patch Tests ; Peru ; Potassium Dichromate ; Skin ; Skin Manifestations

PURPOSE: Colonic polyps are among the most common causes of rectal bleeding in children. We studied the clinical spectrum, histology, malignant potential and treatment of colonic polyps in our cases. METHODS: We reviewed hospital charts of all patients with colonic polyps, seen over a 15-year period from January 1988 to November 2002. Colonoscopy and/or barium enema were done for diagnosis of colonic polyps. Thirty-four children, aged one to 18 years old with colonic polyps, were enrolled in this study. Clinical spectrum, gross appearance, histologic appearance, malignant potential, treatment and prognosis of the colonic polyps were evaluated. RESULTS:The mean age of these patients was 6.4 years, with a male predominance(M:F=1.9:1). All patients had symptoms of rectal bleeding of a mean duration of five months. Solitary polyps were seen in 82.4%(28/34), more than on polyp(all had two polyps) in 11.8%(4/34), juvenile polyposis syndrome in 2.9%(1/34), and Peutz-Jegher syndrome in 2.9%(1/34) of the cases. All but one of the 36 polyps had typical features of a juvenile polyp on histological examination. Adenomatous change was observed in 2.8%(1/36) of juvenile polyps. 94.4%(34/36) of juvenile polyps were located in the rectosigmoid region, 2.8%(1/36) were in the distal colon, and 2.8%(1/36) were in the proximal colon. False negative result of barium enema alone without colonoscopy were found in 25%(2/8), and rectosigmoidscopy alone could miss proximal polyps. Colonoscopic polypectomy or surgical transrectal polypectomy were performed in all cases without major complications. Surgical polypectomy needed general anesthesia in 100%(11/11) of children compared to colonoscopic polypectomy which needed general anesthesia in 23.8%(5/21) of children. Recurrence of polyps was observed only in 2.9%(1/34) of the children. CONCLUSION: Juvenile polyps may be the most common colonic polyps in children. Juvenile polyps should be removed even if asymptomatic because of their neoplastic potential. Because some cases of colonic polyps may be multiple and proximally located, pancolonoscopic polypectomy is recommended in all cases. Surgical polypectomy is less recommended, because general anesthesia is required in all cases and proximal polyps could be missed.
Adolescent ; Anesthesia, General ; Barium ; Child ; Colon* ; Colonic Polyps* ; Colonoscopy ; Diagnosis ; Enema ; Hemorrhage ; Humans ; Male ; Peutz-Jeghers Syndrome ; Polyps ; Prognosis ; Recurrence

Although benign nerve sheath tumors have been described, primary tracheal schwannomas are extremely rare. We report a case of primary tracheal schwannoma, a rare benign nerve sheath tumor in a 58-year-old man with atypical symptoms of chronic cough, sputum and dyspnea for 2 months. Chest computerized tomography showed a 1.7 cm polypoid lesion in posterior wall of mid trachea. The results of bronchoscopic biopsy and immuno-histo-chemical studies were consistent with schwannoma. A surgical treatment of tumor resection and tracheal reconstruction by end-to-end anastomosis was performed.
Biopsy ; Cough ; Dyspnea ; Humans ; Middle Aged ; Nerve Sheath Neoplasms ; Neurilemmoma* ; Sputum ; Thorax ; Trachea

BACKGROUND: Patients with lymph node-negative breast cancer show a 10-year recurrence rate of approximately 20%. In node-negative breast cancer, the prognostic factors are age, menopause, tumor size, hormone receptors, p53, DNA ploidy, Ki-67 index (Ki-67) and c-erbB2. Of these, ErbB2 (the protein of the c-erbB2 gene) is a member of the receptor tyrosine kinase family. Overexpression of ErbB2 is known to regulate cell proliferation, differentiation, growth and apoptosis via the ErbB2/Phosphoinositol 3-Kinase (PI 3-K)/Akt signaling pathway. Therefore, it is important to identify high- risk patients that would benefit from adjuvant therapies related with ErB2. For this purpose, the prognostic relevance of the ErbB2/PI 3-K/Akt pathway was examined in node-negative breast cancer. METHODS: A retrospective analysis was performed on the hospital records of all 72 patients diagnosed with breast cancer, and who underwent surgical treatment between January 1996 and December 2003. Clinicopathological data were compared with the results of immunohistochemical staining using the phospho-specific antibody for the expression of Akt. RESULTS: The mean age of the patient's was 48.6 years. Phospho-Akt (pAkt) was expressed in 24 cases (33.3%), but there was no statistical relationship between pAkt expression and the known prognostic factors of breast cancer. There was no statistical significance in the survival rates between the pAkt positive and negative expression groups (P=0.123). In the ErbB2 positive patients, the expression of pAkt was associated with a shorter disease-free survival (P=0.045), and the disease-free survival was shorter in patients whose tumors expressed pAkt and had a high level of Ki-67 (P=0.040). CONCLUSION: The co-expression of ErbB2 and pAkt positivity implied a poor prognosis in node-negative breast cancer patients, and the co-expression of high Ki-67 and pAkt positivity also revealed a poor prognosis in these patients. These results show that the expression of pAkt could be considered a prognostic marker of node-negative breast cancer with ErbB2 positive expression and high levels of Ki-67.
Apoptosis ; Breast Neoplasms* ; Breast* ; Cell Proliferation ; Disease-Free Survival ; DNA ; Female ; Hospital Records ; Humans ; Menopause ; Ploidies ; Prognosis ; Protein-Tyrosine Kinases ; Recurrence ; Retrospective Studies ; Survival Rate

Sclerosing encapsulating peritonitis (SEP) is characterized by peritoneal fibrosis and adhesion of the peritoneum with the loops of the small intestine. Although the prevalence is low, most cases are caused by peritoneal dialysis, infection, medication, systemic lupus erythematosus (SLE), and intra-abdominal neoplasm. We describe a 22-year old man who was presented with abdominal pain and distension, which were attributed to SLE with peritonitis. He had no specific history of previous medical illness and peritoneal dialysis. He was treated with intravenous high dose methylprednisolone 1 g/day for 3 days, followed by intravenous methylprednisolone 1 mg/kg daily and immunoglobulin. However, his symptoms did not improve. Eventually, a laparoscopic biopsy was performed for an accurate diagnosis. The histopathologic findings were presented in accordance to the typical characteristics of SEP. In spite of medical treatment, he did not show an improvement of clinical symptoms and radiologic findings. As a result, he died from nutritional deficiency, upper gastrointestinal bleeding, and congestive heart failure.
Abdominal Pain ; Biopsy ; Diagnosis ; Heart Failure ; Hemorrhage ; Humans ; Immunoglobulins ; Intestine, Small ; Lupus Erythematosus, Systemic* ; Malnutrition ; Methylprednisolone ; Peritoneal Dialysis ; Peritoneal Fibrosis ; Peritoneum ; Peritonitis* ; Prevalence ; Young Adult

BACKGROUND/AIMS: Low-dose aspirin therapy is widely used to prevent cardiovascular thrombotic events. However, the safety of low-dose aspirin therapy in the gastrointestinal tract is uncertain. Our aim was to evaluate endoscopic findings in patients taking low-dose aspirin. METHODS: Sixty-two patients who received 100 mg enteric coated aspirin daily more than 30 days were included in this study. Patients' medical records and endoscopic data were reviewed retrospectively. As controls, 70 of age- and gender-matched patients who received an endoscopy without gastrointestinal symptoms were employed. RESULTS: The overall prevalence of gastroduodenal mucosal injury was higher in the aspirin group than in the control group. Erosive gastritis was noted more frequently in the aspirin group than in the control group. However, the prevalence of ulcer was not different between the aspirin group and the control group. CONCLUSIONS: Patients treated with low-dose aspirin therapy are more likely to have endoscopic evidence of mucosal damage. Our study suggests that even a low-dose aspirin therapy can induce a gastroduodenal mucosal injury. In the future, a prospective randomized control study is needed.
Aged ; Aspirin/administration & dosage/*adverse effects ; Cardiovascular Diseases/prevention & control ; Esophagitis/chemically induced ; Female ; Gastritis/chemically induced ; Gastrointestinal Diseases/*chemically induced ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/administration & dosage/*adverse effects ; Tablets, Enteric-Coated/adverse effects

BACKGROUND/AIMS: [18F]FDG-PET is a functional imaging modality reflecting cellular glucose metabolism. In most malignant cells, accumulation and trapping of [18F]FDG allows the visualization of increased uptake compared with normal cells. The aim of this study was to assess the value of PET in differentiating benign from malignant hepatic lesions and to determine in which types of hepatic tumors PET can help evaluate stage, monitor response to therapy, and detect recurrence. METHODS: Eighty patients with liver lesions were enrolled (hepatocellular carcinoma 34, cholangiocarcinoma 8, metastatic liver cancer 25, hemangioma 6, liver abscess 7). Liver metastases were 22 adenocarcinoma, 2 lymphoma, 2 squamous cell carcinoma. The PET images of these patients were analyzed. SUV and lesion-to-normal liver background SUV ratio were obtained and compared among the disease groups. RESULTS: All liver metastases and all cholangiocarcinomas had increased uptake value, with SUV ratios greater than 2. Hepatocellular carcinoma had SUV ratios greater than 2 in 20 of 34 patients (59%). All hemangiomas had poor uptake, a SUV ratio of less than 2. All liver abscesses showed definite uptake. CONCLUSIONS: The PET technique using FDG static imaging was useful in differentiating malignant from benign lesions of the liver in limited situations. Limitations included false negative results in some patients with hepatocellular carcinoma. Liver abscesses raised problems in differential diagnosis from malignant liver tumors. The findings of this study suggest that the PET technique might be applied in tumor staging and the detection of recurrence, as well as monitoring responses to therapy for all adenocarcinomas and some hepatocelluar carcinomas.
Adult ; Aged ; Diagnosis, Differential ; English Abstract ; Female ; Fludeoxyglucose F 18/diagnostic use ; Human ; Liver Diseases/*radionuclide imaging ; Liver Neoplasms/radionuclide imaging ; Male ; Middle Aged ; Radiopharmaceuticals/diagnostic use ; *Tomography, Emission-Computed