BACKGROUND/AIMS: Nonalcoholic steatohepatitis (NASH) is chronic liver disease that can potentially progress to end stage liver disease. Oxidative stress to the vulnerable fatty liver has been reported as a key mechanism in development of NASH. Several antioxidant pathways have been identified, but reports that involved quantitative analysis of each antioxidant systems are rare, and these reports have shown various results. So, we investigated antioxidant status and the degree of oxidative stress by measuring several antioxidant enzymes, the total antioxidant status (TAS), and the metabolites of superoxide in NASH patients. METHODS: Nineteen NASH patients who were confirmed by liver biopsy and fifteen controls were involved in this study. The levels of body mass index (BMI), AST, ALT, superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase, TAS, hydrogen peroxide (H2O2), and malondialdehyde (MDA) were compared between both groups. The relationship between the histologic severity and the levels of each antioxidants were analyzed in the NASH group. RESULTS: The activities of SOD and catalase were lower in the NASH group. The concentrations of TAS and H2O2 were higher in NASH group. The level of GPx and MDA showed no significant differences between both groups. There were no significant relationships between the above variables and the pathological severity. CONCLUSIONS: The disturbed metabolism of superoxide due to the decreased activities of SOD and catalase seem to be important in the pathogenesis of NASH. Further investigations about the nonenzymatic secondary antioxidant mechanism are necessary because the TAS was higher for the NASH group. The lack of difference between both groups for the concentration of MDA indicates that mechanisms other than lipid peroxidation also may be important in the pathogenesis of NASH.
Adult ; Antioxidants/*metabolism ; English Abstract ; Fatty Liver/*metabolism/pathology ; Female ; Humans ; Liver/pathology ; Male ; Oxidative Stress

BACKGROUND/AIMS: To determine the treatment modalities and the prognosis of a patient with liver cirrhosis, quantitative estimation of liver function is important. We assessed the Child-Pugh score (CPS), the common method as a severity index for the cirrhosis, the Promthombin, gamma GT, and Apolipoprotein A1 (PGA) index and model for end-stage liver disease (MELD) score. The purpose of this study was to evaluate the correlation between these indices in the patients with cirrhosis only and hepatocellular carcinoma (PHC), according to underlying causes (HBV and alcohol). METHODS: We reviewed medical records of 339 cirrhotic patients with/without hepatocellular carcinoma and divided patient groups by disease and underlying cause: cirrhosis caused by alcohol; LC-Al, cirrhosis caused by HBV; LC-B, hepatocellular carcinoma with cirrhosis caused by alcohol; HCC-Al, hepatocellular carcinoma with cirrhosis caused by HBV; HCC-B. We assessed the CPS, PGA index and MELD score and calculated the correlation coefficient between these scores. RESULTS: Among the total of 339 patients, 201 patients were diagnosed on the liver cirrhosis only, and 138 patients on the hepatocellular carcinoma with cirrhosis. In each groups, mean score values were not significantly different in CPS, PGA index and MELD score. The correlation of CPS, PGA index and MELD score in all groups, except for the correlation of PGA index and MELD score in HCC-Al group, was significantly positive (p<0.05). Compared to correlation coefficients between three indices, the patients with cirrhosis only had higher tendencies than the patients with hepatocellular carcinoma. The patients by HBV had higher tendencies than by alcohol. CONCLUSIONS: The correlations between CPS, PGA index and MELD score showed significantly positive correlations in the patients with liver cirrhosis only and hepatocellular carcinoma with cirrhosis (except in HCC-Al group). The patients with cirrhosis only had higher correlation coefficients than the patients with PHC and the patients by HBV had higher than by alcohol.
Adult ; Aged ; Carcinoma, Hepatocellular/*complications ; Female ; Hepatitis B/*complications ; Humans ; Liver Cirrhosis/*complications ; Liver Cirrhosis, Alcoholic/complications ; Liver Neoplasms/*complications ; Male ; Middle Aged ; Prognosis ; *Severity of Illness Index

The demand for intravenous sedated upper gastrointestianl endoscopy is currently increasing steeply. Despite this trend, patient status complication due to this procedure is largerly neglected by most physicians. Recently, in three patients, mouthpiece fragment were left within the patients' body after intravenous sedated upper gastrointestinal endoscopy. They were transferred to our institution for the removal of the fragment. The patients complained of an uneasy sensation from within their body, around their necks and chests. After conducting therapeutic endoscopy, the fragment could be located around the distal part of their esophagus and within their stomach. The fragment were removed successfully by using snare in two patients, and by using forceps in another patient.
Eating* ; Endoscopy ; Endoscopy, Gastrointestinal* ; Esophagus ; Humans ; Neck ; Sensation ; SNARE Proteins ; Stomach ; Surgical Instruments ; Thorax

BACKGROUND/AIMS: Apolipoprotein E (Apo E) is important in plasma lipid metabolism and is a component of several plasma lipoprotein-lipid particles. Three major Apo E isoforms are encoded by three common allelic forms, epsilon2, epsilon3, and epsilon4 at the APO E locus. The goal of this study was to examine the association between polymorphisms in the apolipoprotein E gene (APOE) and fatty liver disease. METHODS: We examined the distribution of APOE alleles from 116 fatty liver patients and 50 controls in Korea. RESULTS: The frequencies of APOE alleles in fatty liver patients were 6.5% in epsilon2, 85.7% in epsilon3 and 7.8% in epsilon4. The corresponding frequencies in control subjects were 4.0% in epsilon2, 91.0% in epsilon3 and 5.0% in epsilon4. There were no significant differences in the distribution of APOE genotypes between fatty liver patients and controls. APOE epsilon2 and epsilon4 allele frequencies in fatty liver patients were more than those in controls. However, there was no significant differences in APOE epsilon2 and epsilon4 allele frequencies. CONCLUSIONS: These results suggest that APOE alleles seem not to be directly associated with the pathogenesis of fatty liver disease.
Adult ; Aged ; Apolipoproteins E/*genetics ; English Abstract ; Fatty Liver/*genetics ; Female ; Gene Frequency ; Human ; Male ; Middle Aged ; *Polymorphism (Genetics)

Actinomycosis is a rare chronic suppurative disease caused by actinomyces species, which are normal flora in the oral cavity and gastrointestinal tract, and characterized by formation of sulfur granule. Actinomyces can affect cervicofacial, pulmonary, abdominal and pelvic area. However, abdominal and pelvic inflammations are less frequently observed. Most of abdominal actinomycosis develop after abdominal operation, trauma, inflammatory bowel disease or use of intrauterine devices. The definitive diagnosis was made after histopathological study of the tissues. Treatment is long-term antibiotic therapy. Herein, we report a case of a 69-year-old woman with an unusual form of abdominal actinomycosis after total gastrectomy.
Actinomyces ; Actinomycosis* ; Aged ; Diagnosis ; Female ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Intrauterine Devices ; Mouth ; Sulfur ; Upper Gastrointestinal Tract*

OBJECTIVES: This study was performed in order to investigate the frequency of the TNF2 allele in patients with coal workers pneumoconiosis (CWP). METHODS: We compared the genotype distribution of TNFalpha gene promoter polymorphism between 80 CWP patients and 54 healthy controls. RESULTS: The results were as follows : 1. The rare allele TNF2 was significantly more frequent in CWP patients (20.6 %) than in controls (10.2 %). 2. The spontaneous or LPS-induced release of TNFalpha from the peripheral monocytes was slightly increased in the TNF2 group, but these values were not significantly different between groups. 3. In the CWP TNF2 group, the increase of LPS-induced TNFalpha release was significant in comparison with that of the controls. CONCLUSIONS: From the above results, we suggest that the TNF2 allele is strongly associated with susceptibility to CWP development.
Alleles ; Anthracosis ; Coal* ; Genotype ; Humans ; Monocytes ; Pneumoconiosis* ; Tumor Necrosis Factor-alpha*

BACKGROUND: Pneumoconiosis, like other chronic respiratory diseases, is essentially incurable and, for many, pregressive. While improved survival time is an important aim of treatment, there is growing recognition that for some people, improving the quality of life is more important than extending the length of life. Recently the measurement of the quality of life is used to assess the efficacy of therapeutic agents. METHODS: We interviewed 63 pnemoconiotics who were admitted to St. Mary's Hospital between April and August 1999, using COOP charts, Chronic Respiratory Questionnaire (CRQ), and a newly developed questionnaire concerning clinical and socioeconomic features of the pneumoconiotics - Pneumoconiotic Respiratory Questionnaire (PRQ). Also, ILO classification of the chest film, pulmonary function test, and arterial blood gas analysis of the patients were evaluated. Then we compared the scores between insurace assisted and non-insurance assisted patients, and between clinically stable and unstable patients. RESULRS: Domains of CRQ and PRQ showed a high internal consistency reliability (alpha =0.86-0.89, 0.77-0.81) except the dyspnea domain(alpha=0.63) of CRQ. The scores of CRQ and PRQ showed statistically significant correlations with the results of COOP charts, pulmonary function test and arterial blood gas analysis. The dyspnea domain and socia l activity domain of the PRQ showed significant difference between insurance assisted and non-insurance assisted patients, and between clinically stable and unstable patients. CONCLUSION: Korean translation of the Chronic Respiratory Questionnaire and the newly developed Pneumoconiotic Respiratory Questionnaire are reliable and valid method and are likely to be useful for the measuring of quality of life in patients with the chronic respiratory disease including pneumoconiosis.
Blood Gas Analysis ; Classification ; Dyspnea ; Humans ; Insurance ; Longevity ; Pneumoconiosis* ; Quality of Life* ; Surveys and Questionnaires* ; Respiratory Function Tests ; Thorax

OBJECTIVES: The aim of this study is to find out the activity of autoproliferation of ratfibroblast exposed to crystalline silica and the role of mediators secreted from rat fibroblast. METHODS: The effect of alpha-quartz on production of growth factor (platelet-derived growth factor-AA and transforming growth factor beta)from rat fibroblasts were evaluated by ELISA and immunocytochemical analysis. Gene expression of these growth factors in rat fibrobast exposed to crystalline silica was evaluated by RT-PCR. Furthermore, fibroblast proliferation by culture supernatant of rat fibroblast was assayed by the neutral red test. RESULTS: The amounts of H2O2 and growth factors synthesized in rat fibroblasts were significantly increased by the stimulation of crystalline silica(alpha-quartz), which showed the dose-dependent manner to the concentration of alpha-quartz with the maximum response at the dosage of 100 microgram/cm2. The result of RT-PCR demonstrated that alpha-quartz induced gene expression of PDGF-AA and TGFbeta in rat fibroblast. We also found that supernatant of alpha-quartz-cocultured rat fibroblast induced a significant proliferation of fibroblast. CONCLUSION: Crystalline silica directly induce functional change in fibroblast such as increased release of reactive oxygen species and growth factors. The products of these functional change promote fibroblast proliferation via autocrine loop.
Animals ; Crystallins* ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts* ; Gene Expression ; Intercellular Signaling Peptides and Proteins ; Neutral Red ; Rats ; Reactive Oxygen Species ; Silicon Dioxide* ; Transforming Growth Factor beta ; Transforming Growth Factors

Nitric oxide (NO) elevates intracellular calcium. But the actions of calcium in NO-induced cell death are not well understood. This study was carried out to investigate the signal transduction pathways of calcium and NO-induced cytotoxicity in H9c2 cardiac myoblasts by using NO donor compounds such as sodium nitroprusside (SNP) and S-nitroso-N-acetylpenicillamine (SNAP). Pretreatment of intracellular calcium chelating agent (BAPTA/AM) or L-type calcium channel blockers (nicardipine, nifedipine, diltiazem and veraparmil) or T-type calcium channel blocker (flunarizine) blocked SNP-induced cytotoxicity respectively only in a three hours. However, thapsigargin (TG), which inhibits endoplasmic reticulum dependent Ca(2+)-ATPase and thereby increases cytosolic Ca(2+), augmented SNP-induced cytotoxicity. The protective effect of BAPTA/AM was inhibited by treatment of protein synthesis inhibitor, cyclohexamide. In addition, pyrrolidine dithiocarbamate (PDTC), NF-kB inhibitor, attenuates the protective effect of BAPTA/AM against SNP-induced cytotoxicity. It is indicated that the protective effect of BAPTA/AM against NO-induced cytotoxicity might be due to the expression of protein related to activation of NFkB. From these results, it is concluded that SNP-induced cytotoxicity is mediated by calcium in a 3 hours via down regulation of protein expression rleated to activation of NFkB.
Calcium Channels, L-Type ; Calcium Channels, T-Type ; Calcium* ; Cell Death ; Cytosol ; Diltiazem ; Down-Regulation ; Endoplasmic Reticulum ; Humans ; Myoblasts, Cardiac* ; NF-kappa B ; Nifedipine ; Nitric Oxide ; Nitroprusside ; S-Nitroso-N-Acetylpenicillamine ; Signal Transduction* ; Thapsigargin ; Tissue Donors

BACKGROUND/AIMS: The principle of the rapid urease test is the assessment of the color change of the pH indicator, phenol red, by ammonium and bicarbonate ions which were produced by the urease. We modified a conventional rapid urease test, and quantified H. pylori infection by measuring the change of spectrophotometric absorbance. METHODS: 202 patients with upper gastrointestinal symptoms were endoscopically examined and three biopsies were performed in each antrum and fundus. Two biopsy specimens were stained with Giemsa and scored from 0 to 4 according to the distribution of bacteria by the Wyatt method. Another specimen was used for the quantitative rapid urease test. The tissue was incubated in a cuvette containing 10% of urea solution and phenol red at 37C. We measured optical densities in 550 nm at 5 min, 10 min, 15 min, 30 min, 1 hrs, 2 hrs, 4 hrs and 24 hrs time points.
Ammonium Compounds ; Bacteria ; Bicarbonates ; Biopsy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hydrogen-Ion Concentration ; Phenolsulfonphthalein ; Urea ; Urease*