BACKGROUND: Bulla is an air-filled space within the lung parenchyma resulting from deterioration of the alveolar tissue. Molecular mechanism of the formation of the bulla is not well described. Fibroblast growth factor(FGF)-7, bone morphogenetic protein(BMP) receptor, and transforming growth factor(TGF)-beta receptor are known to have a stimulatory or inhibitory role in the lung formation. We investigated to see if these growth factor or cytokine receptors are involved in the bulla formation by immunohistochemical staining of bullous lung tissues from patients with primary spontaneous pneumothorax. MATERIAL AND METHOD: Bullous lung tissues were obtained from 31 patients with primary spontaneous pneumothorax, including 30 males and 1 female from 15 to 39 years old. The bullous tissues were obtained by video-thoracoscopic surgery and/or mini-thoracotomy and fixed in formalin. Blocks of the specimens were embedded with paraffin and cut into 5~6 micrometer thick slices. The sections were deparaffinized and hydrated and then incubated with primary antibodies against FGF-7, BMP-RII, or TGF-RII. RESULT: Of the 31 patients, 24 were TGF-RII positive including 18 strong and 6 weak positives. Observation with high magnification showed that strong immunostaining was detected in the boundary region between bullous and normal lung tissues. In contrast, all of the sections were negative with FGF-7 or BMP-RII antibodies. CONCLUSION: These results suggest that overexpression of TGF-beta RII may be involved in the formation of bulla, although further molecular studies are needed to find out more detailed molecular mechanisms.
Adult ; Antibodies ; Female ; Fibroblasts ; Formaldehyde ; Humans ; Lung ; Male ; Paraffin ; Pneumothorax* ; Receptors, Cytokine ; Transforming Growth Factor beta

PURPOSE: We reviewed the clinical characteristics of skeletal Paget's disease in Korean. MATERIALS AND METHODS: We retrospectively analyzed the clinical features, the responses to treatment and complications of 11 cases of Paget's disease occurred in Korean patients. Then we compared the result obtained with those previously reported. RESULTS: Previous studies have mainly involved the axial skeleton, such as skull, spine or pelvic bone, and the pelvis was the most commonly involved site. In 7 cases, more than one site were involved. Clinical symptoms were pain around the involved sites in 5 cases and claudica-tion associated with spinal stenosis in one case. Serum alkaline phosphatase, a biochemical marker of bone formation, was elevated two to five fold in all cases. Responding to bisphosphate, the clinical symptoms subsided and the levels of alkaline phosphatase were markedly diminished or normalized. No serious complications, such as, cranial neuropathy or a congestive heart failure occurred. CONCLUSION: Compared western reports, Paget's disease of skeletal bone in Koreans showed a much lower incidence rate, milder symp-toms and fewer complications.
Alkaline Phosphatase ; Biomarkers ; Cranial Nerve Diseases ; Heart Failure ; Humans ; Incidence ; Osteogenesis ; Pelvic Bones ; Pelvis ; Retrospective Studies ; Skeleton ; Skull ; Spinal Stenosis ; Spine

OBJECTIVE: To determine the correlation between total anti-oxidant capacity (TAOC)and lipid peroxidase (LPO)levels in serum and disease activity in systemic lupus erythematosus (SLE). METHODS: The study population consisted of 99 patients with SLE according to the 1982 revised ACR criteria and 83 healthy controls.The serum TAOC levels in 99 patients with SLE and 83 healthy controls by the ABTS(R) inhibition method (Randox Ltd,Antrim,UK)and serum malondialdehyde (MDA)levels in 37 out of 99 patients with SLE were measured.Anti-dsDNA antibody (anti-dsDNA),albumin,AST,ALT,cholesterol,uric acid and creatinine were mea-sured to determine the association with the serum TAOC levels.The correlation between the serum TAOC levels and nephritis in 27 cases with nephritis out of 99 SLE patients was also investigated.The SLE disease activity was determined by the SLE disease activity index (SLEDAI)at the time of sample collection. RESULTS: Compared to the controls (1.37 +/- 0.127mmol/L),serum TAOC levels were significantly decreased (1.29 +/- 0.124mmol/L)in SLE patients (p=0.001). And there was a negative correlation between serum TAOC levels and SLEDAI total scores in the SLE patients (r=-0.388,p=0.0001),but no significant correlation between TAOC levels and C3 and anti-dsDNA.Further,a significant difference (p<0.04)in TAOC levels was found in SLE patients with and without nephritis.In comparison with other parameters such as AST,ALT,and cholesterol which might change anti-oxidant level,there was no correlation between the serum TAOC levels and them,except for serum uric acid (r=0.387, p=0.0001),creatinine,and albumin (r=0.507,p=0.0001).Additionally,we couldn't find significant correlation between the serum TAOC levels and MDA. CONCLUSIONS: The serum TAOC levels correlate significantly with SLE disease activity and are associated with nephritis.Also,this study showed a significant correlation with serum albumin levels in these patients.Conclusively,the measurement of the serum TAOC levels in patients with SLE will provide useful information on SLE disease activity.
Cholesterol ; Creatinine ; Humans ; Lupus Erythematosus, Systemic* ; Malondialdehyde ; Nephritis ; Peroxidase ; Serum Albumin ; Uric Acid

OBJECTIVE: To define whether lactase-deficient subjects are intolerable to even a pack of milk(200ml) and whether milk intolerance in the patients with IBD is only due to lactose malabsorption, we performed this study. METHODS: We evaluated 32 healthy adults and 12 patients with active stage of inflammatory bowel disease(IBD) who had not received antibiotics therapy within the previous 3 weeks. Thirty-two healthy adults underwent H2-breath test with 200, 400, 600 and 800ml of milk at 1st, 2nd, 3rd and 4th day of study, respectively. We measured their end-expiratory hydrogen concentrations and asked them to record the gastrointestinal symptoms. Twelve patients with IBD were tested only with 200ml of milk. Lactose malabsorption was defined as the increase of 20ppm over basal H2 concentration and lactose intolerance as having two or more of the following symptoms; abdominal pain, diarrhea, borborygmus and flatus. RESULTS: The prevalence of lactase deficiency was 72%(23 of 32 subjects) at 800ml of milk(lactose 40g). Among the lactase-deficient subjects, lactose intolerance at 200ml of milk(lactose 10g) was noticed only in 13%(3 of 23 subjects). In the patients with active stage of IBD, the frequency of milk intolerance at 200ml of milk was 50%(6 of 12 subjects), which was higher than in the healthy adults(9%). But the prevalence of lactose malabsorber in the patients with IBD at 200ml of milk(17%) was not higher than in the healthy adults(16%). CONCLUSION: Most of lactase-deficient subjects(87%) can ingest one pack of milk without lactose intolerance. The increased prevalence of lactose intolerance in the patients with IBD at 200ml of milk is not originated from lactose malabsorption, but probably from incomplete colonic compensation salvage.
Abdominal Pain ; Adult ; Anti-Bacterial Agents ; Colon ; Compensation and Redress ; Diarrhea ; Drinking* ; Flatulence ; Humans ; Hydrogen ; Inflammatory Bowel Diseases* ; Lactase* ; Lactose Intolerance* ; Lactose* ; Milk* ; Prevalence

Chronic idiopathic inflamatory bowel disease, espcaially Crohn's disease, is frequently complicated with low gastrointestinal stricture. Besides medical treatment of active inflammation, there is no specific, conservative approach to this complication, Repetitive surgery with extensive resections, leading to short bowel syndrome, is often necessary. Balloons have been used for a variety of gastrointestinal stenoses including esophageal, small intestinal, and colonic stricture. Balloon dilation offers many theoretical advantages (safety, and patient comfort) over dilation with bougies. Especially, the availability of large diameter balloon dilators, which pass through the biopsy channel of standard endoscopes (through-the scope balloon or TTS balloon), has promised efficient direct-vision dilatation of strictures without the need of guide wires or fluoroscope. We report a case of colonic Crohn's stricture dilated successfully using TTS balloon catheter.
Biopsy ; Catheters ; Colon* ; Constriction, Pathologic* ; Crohn Disease ; Dilatation ; Endoscopes ; Humans ; Inflammation ; Short Bowel Syndrome

Brunner's gland hamartomas are rare duodenal tumors with characteristic pathologic featmes. The usual clinical presentation is nonspecific symptoms, obstructive symptoms, or intestinal bleeding. The majority of these tumors are less than 3 cm in diameter. In cases of larger size, the manifestations are usually intestinal obstruction or intestinal bleeding. The cases with massive gastrointestinal bleeding and severe anemia, requiring transfusion are rare. The diagnosis is made by radiologic studies and gastroduodenoscopy. The treatment of Brunner's gland hamartomas should be conservative, since they are not premalignant, However, the lesions originate in the submucosa, so the confimative diagnosis usually cannot be made by endoscopie biopey. For definitive diagnosis and relief of symptoms, the lesions must be removed surgically or endoscopically. Endoscopic excision is indicated if the tumar is pedunculated. We recently experienced a case of Brunner's gland hamartoma of about 5.5 cm in diameter with intestinal bleeding, requiring transfusion and intussusception. Preoperative diagnosis was submucosal tumor, such as lymphoma, with duodeno-duodenal intussusception. After surgical removal, the resected specimen showed the histologic features of Bruaner's gland hamartoma.
Anemia* ; Diagnosis ; Duodenum ; Hamartoma* ; Hemorrhage ; Intestinal Obstruction ; Intussusception* ; Lymphoma

BACKGROUND/AIMS: The reflux alkaline gastritis and esophagitis are important late complications after gastric surgery. Endoscopy is primary diagnostic tool for them. But, the clinical significance of gastritis and esophagitis diagnosed by endoscopy is not well known. We evaluated the correlation between the alkaline reflux gastritis and esophagitis and their symptoms and we also examined their prevalence according to types of surgery. METHODS: The 111 gastroresected patients who had had upper endoscopy by one endoscopist were evaluated. We reviewed all their medical records, and interviewed 54 patients by telephone to evaluate symptoms. RESULTS: Endoscopic reflux alkaline gastritis was observed in 38 patients(45%) with Billroth-II gastrectomy and in 4 patients(33%) with Bil]roth-I gastrectomy. But, there was no symptomatic difference between group with and without endoscopic reflux gastritis. Moreover, none of them had typical reflux gastritis symptom complex including billous vomiting. In all patients with total gastrectomy and loop esophagojejunostomy, endoscopic reflux esophagitis was observed. But, there was no case af endoscopic reflux esophagitis in the patients with total gastrectomy and Roux-en-Y anastomosis. There was significant symptomatic correlation between group with and without endoscopic reflux esophagitis. T'he incidence of reflux esophagitis had no difference between Billroth-II gastrectomy and Billroth-I gastrectomy. CONCLUSION: The endoscopic alkaline reflux gastritis had poor symptematic correlation. In the case of total gastrectomy, for the prevention of reflux esophagitis, Roux-en-Y anastomosis is better than loop esophagojejunostomy.
Anastomosis, Roux-en-Y ; Endoscopy ; Esophagitis* ; Esophagitis, Peptic ; Gastrectomy ; Gastritis ; Humans ; Incidence ; Medical Records ; Prevalence ; Telephone ; Vomiting

Collagenous colitis is characterized clinically by chronic watery diarrhea and pathologically by increased subepithelial collagen deposition associated with an inflammatory infiltrate in the lamina propria. Its etiology is still unclear, although a variety of associated diseases such as rheumatic syndromes, scleroderma, and thyroid diseases have been reported. We report a case of collagenous colitis following the prolonged use of NSAIDs. A 72-year-old woman who has taken NSAIDs for many years due to some dermatologic problems was admitted to the hospital because of chronic watery diarrhea and colicky abdominal pain of 3 months duration. There was no abnormal physical finding except cachectic appearance due to weight loss of 10kg during 3 months. Stool examination for ova and parasites and fat was negative, and stool culture for bacterial pathogens was negative. In complete blood count, there were relative eosinophila and mild anemia. Total serum protein and albumin was low, and thyroid function, RA factor, FANA were all normal. Results of upper and lower gastrointestinal contrast radiographs were normal. Sigmoidoscopy revealed normal colonic mucosa but she had a thick subepithelial collagenous deposit and chronic inflammation in lamina propria on colonic biopsy. Based on the above findings, she was diagnosed as collagenous colitis. Diarrhea improved after withdrawing NSAIDs and the treatment with oral prednisolone. In the post-treatment biopsy, the thickness of the collagen hand was diminished. Collagenous colitis is now recognized as one of the common causes of chronic diarrhea of obscure origin and NSAIDs may play an etiological role in some patient with collagenous colitis.
Abdominal Pain ; Aged ; Anemia ; Anti-Inflammatory Agents, Non-Steroidal ; Biopsy ; Blood Cell Count ; Colitis, Collagenous* ; Collagen* ; Colon ; Diarrhea ; Female ; Hand ; Humans ; Inflammation ; Mucous Membrane ; Ovum ; Parasites ; Prednisolone ; Sigmoidoscopy ; Thyroid Diseases ; Thyroid Gland ; Weight Loss

Cytomegalovirus(CMV) infection in normal adults and children is usually asymptomatic. However, CMV represents a potent opportunistic pathogen in immunocompromised hosts, such as neonate, victims of acquired immune deficiency syndrome, organ transplant recipients, and patients receiving immunosuppressive chemotherapy, in whom the virus is capable of causing severe morbidity and mortality. We report three cases of CMV retinitis in the kedney transplat. patients who had been treated with immunosuppressants after transplant.
Acquired Immunodeficiency Syndrome ; Adult ; Child ; Cytomegalovirus Retinitis* ; Cytomegalovirus* ; Drug Therapy ; Humans ; Immunocompromised Host ; Immunosuppressive Agents ; Infant, Newborn ; Kidney* ; Mortality ; Retinitis ; Transplants

BACKGROUND: In order to investigate the effects of intensive training on cardiorespiratory response to maximal exercise in soccer players, graded excercise stress tests were carried out before and after the training, and the results were compared. METHODS: Fourteen male soccer players of a university team with the mean age and career of 19.9 and 7.8 years, respectively, underwent intensive training for approximately 20 weeks, 6 days a week and 4 hours a day, which included running of 2 km daily during the last 8-9 weeks. The symptom-limited maximal exercise test was done by Bruce protocol. RESULTS: After the training. HR max showed no significant changes but Vo2 max, O2 pulse and AT were increased approximately 13%, 12% and 10%, respectively. At maximal exercise, the V(E)/M2 was also increased 18%, but VE/MVV was significantly decreased owing to a marked increase in MVV. However, the rest of various ventilatory parameters showed no significant changes. CONCLUSION: These data indicate that the intensive training of about 20 weeks duration can further improve the level of cardiorespiratory fitness in the soccer players who have been regularly trained and are already highly fit.
Exercise Test ; Humans ; Male ; Running ; Soccer*