PURPOSE: This study aimed to assess the role of thiopurine S-methyltransferase (TPMT) and 6-thioguanine nucleotide (6-TGN) as predictors of clinical response and side effects to azathioprine (AZA), and estimate the optimal AZA dose in Korean pediatric inflammatory bowel disease (IBD) patients. MATERIALS AND METHODS: One hundred and nine pediatric IBD patients in whom AZA treatment was required were enrolled. Thiopurine metabolites were monitored since September 2010. Among them, 83 patients who had prescribed AZA for at least 3 months prior to September 2010 were enrolled and followed until October 2011 to evaluate optimal AZA dose, adverse effects and disease activity before and after thiopurine metabolite monitoring. RESULTS: The result of the TPMT genotype was that 102 patients were *1/*1 (wild type), four were *1/*3C, one was *1/*6, one was *1/*16 (heterozygote) and one was *3C/*3C (homozygote). Adverse effects happened in 31 patients pre-metabolite monitoring and in only nine patients post-metabolite monitoring. AZA dose was 1.4+/-0.31 mg/kg/day before monitoring and 1.1+/-0.46 mg/kg/day after monitoring (p<0.001). However, there were no statistical differences in disease activity during metabolite monitoring period (p=0.34). Adverse effects noticeably decreased although reduction of the AZA dose since monitoring. CONCLUSION: TPMT genotype and thiopurine metabolite monitoring could be helpful to examine TPMT genotypes before administering AZA and to measure 6-TGN concentrations during prescribing AZA in IBD patients.
Adolescent ; Adult ; Azathioprine/*adverse effects/therapeutic use ; Child ; Child, Preschool ; Female ; Genotype ; Guanine Nucleotides/metabolism ; Humans ; Inflammatory Bowel Diseases/*drug therapy/metabolism ; Male ; Methyltransferases/genetics/metabolism ; Republic of Korea ; Risk Factors ; Thionucleotides/metabolism ; Treatment Outcome

We examined the fibronectin (FN) secretion of cultured trabecular meshwork (TM) cells in a normal human eye by indirect immunofluorescent technique using mouse anti-human FN monoclonal antibody and FITC-conjugated goat anti-mouse IgG. To localize FN on frozen sections of normal TM, which were obtained from 7 enucleated eyes owing to traumatic eyeball rupture, the same indirect immunofluorescent method was used. Immunoelectron microscopy was applied to demonstrate the distribution pattern of FN in the normal TM of 2 human eyes using an avidin-biotin-peroxidase complex method. In the tissue culture of TM, the TM cell walls and extracellular matrices showed an intense staining with antibody to FN. Indirect immunofluorescent staining of FN on frozen sections of TM showed strong positive reactions in the subendothelial region. There was no reaction in the central core of the trabecular beam. Immunoelectron microscopy revealed the reaction products to FN in the areas lining the trabecular endothelial cells.
Adolescent ; Adult ; Antibodies, Monoclonal ; Cells, Cultured ; Fibronectins/biosynthesis/*metabolism ; Fluorescent Antibody Technique ; Humans ; Male ; Microscopy, Immunoelectron ; Trabecular Meshwork/*metabolism/ultrastructure

No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibromin 1 ; Vitiligo*

We examined the fibronectin(FN) secretion by cultured trabecular meshwork(TM) cells from a normal human eye by indirect immunofluorescent technique using mouse anti-human FN monoclonal antibody and FITC-conjugated goat anti-mouse IgG. To localize FN on frozen sections of normal TM which were obtained from 7 enucleated eyes owing to traumatic eyeball rupture, the same indirect immunofluorescent method was used. Immunoelectron microscopy was applied to demonstrate the distribution pattern of FN in the normal TM of 2 human eyes using an avidin-biotin-peroxidase complex method. In tissue culture of TM, TM cell walls and extracellular matrices showed an intense staining with antibody to FN. Indirect immunofluorescent staining of FN on frozen sections of TM showed strong positive reactions in the subendothelial region. There was no reaction in the central core of the trabecular beam. Immunoelectron microscopy revealed the reaction products to FN in the areas lining the trabecular endothelial cells.
Animals ; Cell Wall ; Endothelial Cells ; Extracellular Matrix ; Fibronectins* ; Fluorescent Antibody Technique, Indirect ; Frozen Sections ; Goats ; Humans ; Immunoglobulin G ; Mice ; Microscopy, Immunoelectron ; Rupture ; Trabecular Meshwork*

PURPOSE: Papillary thyroid microcarcinomas (PTMCs) have the same histological features as papillary thyroid cancer, but they are 1.0 cm or less in diameter. They can metastasize to the regional lymph nodes and distant sites, but its ability to cause significant morbidity and mortality has been questioned. Because of this reason, the extent of thyroid tumor resection remains an issue of controversy. This study is aimed at identifying the statistically significant factors that are associated with recurrence and we also wanted to devise an appropriate surgical treatment plan for PTMC patients. METHODS: The retrospective review (350 cases, 1990.1~2004. 11) was obtained from Seoul National University Hospital (SNUH). The mean age at the time of diagnosis was 46.5± 11.0 (yrs) (range: 12~75). The mean overall length of follow- up was 37.70± 36.03 months (range: 1~169). The PTMCs were treated with total and subtotal thyroidectomy or lobectomy. The invasiveness and lymph node metastasis (LNM) from 350 PTMCs were analyzed according to the size, multiplicity, bilaterality of the tumor and the perithyroidal invasion. Fishers exact test and the exact logistic regression test were used for the stratified analysis. RESULTS: 350 of the 2187 papillary carcinoma were PTMCs. There were 296 females (84.6%) and 54 males (15.4%) in the study. Invasion into the perithyroidal tissue was common (128/336, 38.1%). There were 68 patients with LNM among the 312 total patients (21.7%). The group with either perithyroidal invasion or LNM showed a significantly higher recurrence rate than those group having neither one (4.8% vs. 10.9%, 4.5% vs. 19.1%, respectively). Even for tumor smaller than 1 cm, a larger-sized tumor resulted in a poorer prognosis. CONCLUSION: PTMC is an early stage carcinoma with the capability of tissue invasion, lymph node metastasis and multiplicity. Based on this study, total thyroidectomy is recommended for significant portion of the PTMCs. Furthermore, more careful imaging studies (such as neck ultrasonography or neck CT scan) are needed to detect contralateral lesions or neck lymph node metastasis.
Carcinoma, Papillary ; Diagnosis ; Female ; Humans ; Logistic Models ; Lymph Nodes ; Male ; Mortality ; Neck ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Ultrasonography

Collagenous gastritis, a counterpart of collagenous colitis, is an extremely rare disorder. The first case of collagenous gastritis in a Korean boy in his preteens who had been receiving treatment for refractory iron deficiency anemia has been reported. The patient had been suffering from intermittent abdominal pain, recurrent bloodtinged vomiting and poor oral intake. The gastric endoscopy revealed diffuse cobblestone appearance of the mucosa with easy touch bleeding throughout the stomach but no abnormalities in the esophagus, duodenum, and colon. Pathologic examination of the gastric biopsies from the antrum, body and cardia showed a subepithelial collagen deposition with entrapped dilated capillaries, moderate infiltrates of lymphoplasma cells and eosinophils of the lamina propria, and marked hypertrophy of the muscularis mucosa. The collagen deposition appeared as discontinuous bands with focally irregular extension into the deeper part of the antral mucosa. It measured up to 150 micrometer. Helicobacter pylori infection was not detected. The biopsies from the duodenum, esophagus and colon revealed no pathologic abnormalities.
Biopsy ; Child ; Colitis/*diagnosis/pathology ; Collagen/metabolism ; Endoscopy ; Gastric Mucosa/pathology ; Gastritis/pathology ; Gastrointestinal Hemorrhage/diagnosis/pathology ; Helicobacter pylori/metabolism ; Humans ; Korea ; Male ; Mucous Membrane/pathology ; Stomach Diseases/diagnosis/pathology

No abstract available.
Acanthoma* ; Scrotum*

BACKGROUND: Previous studies have suggested synergistic analgesic drug interactions between NSAIDs and opioids in neuropathic and inflammatory pain models. The aim of this study was to investigate the analgesic drug interaction between intraperitoneal (IP) ketorolac and morphine in radiant thermal stimulation rat. METHODS: Initially, we assessed the withdrawal latency time of the hindpaw to radiant thermal stimulation every 15 min for 1 hour and every 30 min for next 1 hour after IP normal saline 5 ml (control group). The latency time was changed into percent maximal possible effect (%MPE). Next, IP dose response curves were established for the %MPE of morphine (0.3, 1, 3, 10 mg/kg) and ketorolac (3, 10, 30 mg/kg) to obtain the ED50 for each agent. And we confirmed that the IP morphine effect was induced by opioid receptor through IP morphine followed by IP naloxone. At last, we injected three doses of IP ketorolac (3, 10, 30 mg/kg) mixed with one dose of morphine (2 mg/kg) for fixed dose analysis. RESULTS: IP morphine delayed the paw withdrawal latency time dose dependently, but not ketorolac. ED50 of IP morphine was 2.1 mg/kg. And the IP morphine effect was reversed to control level by IP naloxone. IP ketorolac + morphine combination showed no further additional effects on paw withdrawal latency time over morphine only group. CONCLUSIONS: IP ketorolac did not produce antinociceptive effect during radiant thermal stimulation. There was neither additional nor synergistic analgesic interaction between IP morphine and ketorolac in thermal stimulation rat.
Analgesics, Opioid ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; Drug Interactions ; Ketorolac* ; Morphine* ; Naloxone ; Rats* ; Receptors, Opioid

PURPOSE: Recently the theory has been developed that host genetic factor affects interleukin (IL)-1beta might exert an influence on the divergent clinical outcomes. We evaluated the roles of H. pylori infection and polymorphism of IL-1beta in the carcinogenesis of gastric adenocarcinoma. METHODS: Gastric cancer tissues from 68 patients, peripheral blood from 43 controls, and various gastric cancer cell lines (MKN45, MKN74, SNU620, SNU638, SNU216, SNU601, and AGS) were used. Single nucleotide polymorphism (SNP) of IL-1beta-31 and the length of tandem repeat of IL-1RN were analyzed by PCR and automatic DNA sequencer. IL-1beta mRNA expressions from gastric cancer tissues were measured using semiquantitative RT-PCR and compared according to SNP of IL-1beta-31. We also investigated the IL-1beta-31 SNP from various cancer cell lines and measured IL-1beta mRNA and protein expressions using semiquantitative RT- PCR and ELISA. We constructed reporter systems for IL-1beta-31T/T and IL-1beta-31C/C and the responses to antigen PMA and H. pylori were compared. RESULTS: We couldn't find any significant difference in the frequencies of IL-1beta-31 SNP and IL-1RN polymorphism between the gastric cancer and control groups. IL-1beta mRNA and protein expression were significantly more highly responsive to PMA at IL-1beta-31 T/T type as compared with those of C/T or C/C type when studied in gastric cancer cell lines, although we couldn't find any significant difference of IL-1beta mRNA expression according to IL-1beta-31 SNP when studied in gastric cancer tissue. When we compared the activities of reporter systems, the basal luciferase activity, response to PMA, and response to H. pylori of reporter genes was 1.30-fold, 1.32-fold, and 1.62-fold higher respectively in pIL-1beta T/T type as compared with pIL-1beta C/C type. CONCLUSIONS: These findings indicate that SNP of IL-1beta exerts an influence on the expression of IL-1beta and there is a significant difference in response to environmental factors. They also suggest that the host with IL-1beta-31 T/T type has a higher risk of hypochlorhydria, gastric atrophy, and after all gastric cancer in response to H. pylori infection. However the relationship between polymorphism of IL-1beta and gastric adenocarcinoma require further study.
Achlorhydria ; Adenocarcinoma ; Atrophy ; Carcinogenesis ; Cell Line ; DNA ; Enzyme-Linked Immunosorbent Assay ; Genes, Reporter ; Helicobacter pylori* ; Helicobacter* ; Humans ; Interleukin-1beta* ; Interleukins ; Luciferases ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; RNA, Messenger ; Stomach Neoplasms* ; Tandem Repeat Sequences

PURPOSE: This study was designed to determine the effectiveness of fibrin tissue glue for reducing the amount of drainage and shortening the hospital stay. METHODS: 255 patients who underwent thyroidectomy due to papillary thyroid carcinoma (179 cases of total thyroidectomy and 76 cases of total thyroidectomy with unilateral modified radical neck dissection) were analyzed retrospectively. The clinical factors were compared between the case group (fibrin glue) and the control group (conventional hemostasis). This comparison was separately done for the cases of total tyroidectomy alone and for the cases of total thyroidectomy with MRND. RESULTS: There were no significant differences between the two groups for the amount of drainage and the length of the hospital stay for patients who underwent total thyroidectomy alone. On the other hand, for patients who underwent total thyroidectomy with unilateral MRND, a significant reduction of the average amount of drainage (case group: 37.52±9.41 ml, control group: 42.89±10.82 ml, P*=0.025) and a significantly shortened hospital stay (case group: 3.43±0.50 days, control group: 3.75±0.69 days, P*=0.021) were observed in the case group. CONCLUSION: From the results of this study, we recommend the use of fibrin glue after extensive radical neck surgery such as modified radical neck dissection. Prospective randomized studies should be carried out to confirm and expand our results.
Adhesives* ; Drainage ; Fibrin Tissue Adhesive ; Fibrin* ; Hand ; Humans ; Length of Stay ; Neck ; Neck Dissection ; Prospective Studies ; Retrospective Studies* ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy