OBJECTIVE: Cell to cell and cell to extracellular matrix interaction are crucial in tumor development and progression. Tight junction proteins such as claudins and zonula occludens-1 (ZO-1) play an important role in these processes. This study was performed to investigate the difference of expressions of claudin-1, claudin-4 and ZO-1 in low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL), and invasive squamous cell carcinoma (ISCC) of the uterine cervix. METHODS: The expressions of claudin-1, claudin-4 and ZO-1 were evaluated using immunohistochemical staining in 78 cervical tissue specimens (LSIL 22 case, HSIL 36 case, and ISCC 20 case). RESULTS: Claudin-1 expression was positive in 40.9% of LSIL, in 94.0% of HSIL and in 20.0% of ISCC. The expression of claudin-1 was significantly high in HSIL (p=0.0001). Claudin-4 expression was positive in 31.8% of LSIL, in 41.7% of HSIL and in 25.0% of ISCC. The expression of claudin-4 was high in HSIL, but it was not statistically different. ZO-1 expression was positive in 13.6% of LSIL, in 41.7% of HSIL, and in 25.5% of ISCC. The expression of ZO-1 was significantly high in HSIL (p=0.011). CONCLUSION: These results indicate increased expressions of claudin-1 and ZO-1 in the HSIL that includes cervical intraepithelial neoplasia (CIN) 2 and 3, which decrease during progression to cervical cancer.
Carcinoma, Squamous Cell* ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Claudin-1* ; Claudin-4* ; Claudins ; Extracellular Matrix ; Female ; Tight Junction Proteins ; Uterine Cervical Neoplasms

BACKGROUND: Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis, including stimulating the proliferation and migration of vascular smooth muscle cells (VSMCs). It has been known that diabetes is associated with accelerated cellular proliferation via VEGF, as compared to that under a normal glucose concentration. We investigated the effects of selective blockade of a VEGF receptor by using anti-Flt-1 peptide on the formation and hyperplasia of the neointima in balloon injured-carotid arteries of OLETF rats and also on the in vitro VSMCs' migration under high glucose conditions. MATERIAL AND METHOD: The balloon-injury method was employed to induce neointima formation by VEGF. For 14 days beginning 2 days before the ballon injury, placebo or vascular endothelial growth factor receptor-1 (VEGFR-1) specific peptide (anti-Flt-1 peptide), was injected at a dose of 0.5 mg/kg daily into the OLETF rats. At 14 days after balloon injury, the neointimal proliferation and vascular luminal stenosis were measured, and cellular proliferation was assessed by counting the proliferative cell nuclear antigen (PCNA) stained cells. To analyze the effect of VEGF and anti-Flt-1 peptide on the migration of VSMCs under a high glucose condition, transwell assay with a matrigel filter was performed. And finally, to determine the underlying mechanism of the effect of anti-Flt-1 peptide on the VEGF-induced VSMC migration in vitro, the expression of matrix metalloproteinase (MMP) was observed by performing reverse transcription-polymerase chain reaction (RT-PCR). RESULT: Both the neointimal area and luminal stenosis associated with neointimal proliferation were significantly decreased in the anti-Flt-1 peptide injected rats, (0.15+/-0.04 mm2 and 36.03+/-3.78% compared to 0.24+/-0.03 mm2 and 61.85+/-5.11%, respectively, in the placebo-injected rats (p<0.01, respectively). The ratio of PCNA(+) cells to the entire neointimal cells was also significantly decreased from 52.82+/-4.20% to 38.11+/-6.89% by the injected anti-Flt-1 peptide (p<0.05). On the VSMC migration assay, anti-Flt-1 peptide significantly reduced the VEGF-induced VMSC migration by about 40% (p<0.01). Consistent with the effect of anti-Flt-1 peptide on VSMC migration, it also obviously attenuated the induction of the MMP-3 and MMP-9 mRNA expressions via VEGF in the VSMCs. CONCLUSION: Anti-Flt-1 peptide inhibits the formation and hyperplasia of the neointima in a balloon-injured carotid artery model of OLETF rats. Anti-Flt-1 peptide also inhibits the VSMCs' migration and the expressions of MMP-3 and MMP-9 mRNA induced by VEGF under a high glucose condition.
Animals ; Arteries ; Carotid Arteries ; Cell Proliferation ; Constriction, Pathologic ; Endothelial Growth Factors* ; Glucose ; Hyperplasia ; Muscle, Smooth, Vascular* ; Neointima* ; Phenobarbital ; Rats* ; Rats, Inbred OLETF ; Receptors, Vascular Endothelial Growth Factor ; RNA, Messenger ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factor Receptor-1

OBJECTIVE: To evaluate the perinatal outcomes and maternal complications associated with triplet pregnancies. METHODS: Medical records of consecutive triplet pregnancies delivered in ( )( )Hospital from 1997 to 2005 were reviewed for maternal and neonatal outcomes. Pregnancies associated with lethal congenital anomalies or the case that being delivered before 20 weeks of gestation were excluded. Neonatal outcomes included respiratory distress syndrome, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage and low Apgar scores, congenital anomaly and so on. Maternal outcomes included preeclampsia, preterm delivery, anemia and blood transfusion and so on. RESULTS: The mean gestational age at delivery was 31.5+/-4.1 weeks, and the mean birth weight for triplets was 1,654.4+/-578.1 g. 31 of total 39 neonates (79.5%) were admitted to the neonatal intensive care unit, and 9 neonates (23.1%) received mechanical ventilator care as well. Neonatal death occurred in 6 of 39 neonates (15.4%). Congenital anomaly was seen in 3 of 39 neonates (7.7%). Hyperbilirubinemia developed in 16 of 39 neonates (44.4%). Respiratory distress syndrome developed in 3 of 39 neonates (7.7%). The most common maternal complication was preterm labor (76.9%), followed by anemia (46.1%), preterm premature rupture of membrane (30.8%) and blood transfusion (7.7%). Five patients (5/13, 38.5%) received tocolytic therapy. CONCLUSION: The main cause of neonatal death in triplet pregnancies is the respiratory distress syndrome in extreme preterm delivery. The most common neonatal morbidities are hyperbilirubinemia and apnea of prematurity. There is no difference in neonatal outcomes according to birth order. The most common maternal complications are preterm delivery and anemia. The adverse outcomes of triplet pregnancies are mainly due to preterm delivery.
Anemia ; Apnea ; Birth Order ; Birth Weight ; Blood Transfusion ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Membranes ; Obstetric Labor, Premature ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Triplet* ; Retinopathy of Prematurity ; Rupture ; Tocolysis ; Triplets* ; Ventilators, Mechanical

OBJECTIVE: To evaluate the perinatal outcomes and maternal complications associated with triplet pregnancies. METHODS: Medical records of consecutive triplet pregnancies delivered in ( )( )Hospital from 1997 to 2005 were reviewed for maternal and neonatal outcomes. Pregnancies associated with lethal congenital anomalies or the case that being delivered before 20 weeks of gestation were excluded. Neonatal outcomes included respiratory distress syndrome, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage and low Apgar scores, congenital anomaly and so on. Maternal outcomes included preeclampsia, preterm delivery, anemia and blood transfusion and so on. RESULTS: The mean gestational age at delivery was 31.5+/-4.1 weeks, and the mean birth weight for triplets was 1,654.4+/-578.1 g. 31 of total 39 neonates (79.5%) were admitted to the neonatal intensive care unit, and 9 neonates (23.1%) received mechanical ventilator care as well. Neonatal death occurred in 6 of 39 neonates (15.4%). Congenital anomaly was seen in 3 of 39 neonates (7.7%). Hyperbilirubinemia developed in 16 of 39 neonates (44.4%). Respiratory distress syndrome developed in 3 of 39 neonates (7.7%). The most common maternal complication was preterm labor (76.9%), followed by anemia (46.1%), preterm premature rupture of membrane (30.8%) and blood transfusion (7.7%). Five patients (5/13, 38.5%) received tocolytic therapy. CONCLUSION: The main cause of neonatal death in triplet pregnancies is the respiratory distress syndrome in extreme preterm delivery. The most common neonatal morbidities are hyperbilirubinemia and apnea of prematurity. There is no difference in neonatal outcomes according to birth order. The most common maternal complications are preterm delivery and anemia. The adverse outcomes of triplet pregnancies are mainly due to preterm delivery.
Anemia ; Apnea ; Birth Order ; Birth Weight ; Blood Transfusion ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Membranes ; Obstetric Labor, Premature ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Triplet* ; Retinopathy of Prematurity ; Rupture ; Tocolysis ; Triplets* ; Ventilators, Mechanical

Midventricular obstructive hypertrophic cardiomyopathy (MOHCM) is a rare variant of hypertrophic cardiomyopathy. Apical dilatation and myocardial infarction can be complicated without significant coronary artery disease. We report a case of apical dilatation in a patient with MOHCM without atherosclerotic coronary artery disease. A 76-year-old woman was admitted for recent cerebral infarction and consulted to cardiologist for abnormal electrocardiographic findings. She had been suffering from exertional dyspnea (NYHA II) for about four years. Two dimentional-echocardiography revealed midventricular obstructive hypertrophy with an apical dilatation and paradoxical jet flow from the apical aneurysm to the left ventricular outflow tract during early diastole. Cardiac catheterization demonstrated dyskinesia in the apical wall with midventricular obstruction and a peak-to-peak intraventricular pressure gradient of 110 mmHg during pull-back from the apical high-pressure chamber to the subaortic low-pressure chamber in the left ventricle. Coronary angiograms showed no significant stenotic lesion of the coronary arteries. She was prescribed oral beta-adrenergic antagonist to decrease the intraventricular pressure gradient.
Aged ; Aneurysm* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Cerebral Infarction ; Coronary Artery Disease ; Coronary Vessels ; Diastole ; Dilatation* ; Dyskinesias ; Dyspnea ; Electrocardiography ; Female ; Heart Ventricles ; Humans ; Hypertrophy ; Myocardial Infarction ; Ventricular Pressure

Despite the advent of new antimicrobial drugs and mordern imaging techniques, mortality and morbidity of bacterial meningitis remain high. The unfavorable clinical outcomes are due to intracranial complications such as cerebrovascular complications, hydrocephalus, cerebral edema, intracerebral hemorrhage, brain abscess, and convulsion. Prompt identification and treatment of each are essential to mininize unfavorable outcomes. We report two cases of cerebral infarctions complicated by Streptococcus pneumoniae meningitis with a brief review of related literatures.
Brain Abscess ; Brain Edema ; Cerebral Hemorrhage ; Cerebral Infarction* ; Hydrocephalus ; Meningitis, Bacterial ; Meningitis, Pneumococcal* ; Mortality ; Seizures ; Streptococcus pneumoniae* ; Streptococcus* ; Thrombosis

PURPOSE: Chemotherapy is the treatment of choice for small-cell lung cancer (SCLC). Despite the high response rates with first-line therapy, most patients eventually experience disease progression, and finally become candidates for second-line therapy. Topotecan is the only single agent currently approved in the United States for the treatment of a recurrent disease. The aim of this study was to evaluate its efficacy in patients with of previously treated, but relapsed and refractory, SCLC. MATERIALS AND METHODS: Twenty-five patients, who had taken topotecan as a second-line therapy, between March 1999 and October 2002, were reviewed. The patients were divided into two groups: (1) One group were the patients that had failed the first-line treatment within 3 months from end of the chemotherapy (refractory group, RG); and (2) the other group were those that responded to the first-line treatment, but who progressed 3 months after the end of the chemotherapy (sensitive group, SG). Topotecan was administered, intravenously, at a dose of 1.5 mg/m2, within 30 minutes, for five consecutive days every 3 weeks. RESULTS: There was only one partial response in the SG (3.8%), but there were 9 stable diseases, 4 in the SG and 5 in the RG; 15.4 and 19.2%, respectively. The median survivals were 6.9 and 5.2 months in SG and RG, respectively (p=0.162). There were ninety-nine chemotherapy cycles. The toxicities were mainly hematological. There were 26 incidences of Grades III and IV neutropenia, and the non hematological toxicities were mild. CONCLUSION: It was concluded that topotecan is not so effective in the treatment of patients with relapsed and refractory SCLC, despite its predictable and manageable toxicity. The incorporation of topotecan in combination chemotherapy regimens for treatment of SCLC is now warranted.
Disease Progression ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Neutropenia ; Retrospective Studies* ; Topotecan* ; United States

BACKGROUND AND OBJECTIVES: The leukotriene (LT) receptor antagonist is subject to an on-going study of allergic rhinitis, nasal polyposis and chronic paranasal sinusitis. This study was designed to evaluate the change of nasal patency and morphological changes by assessing the role of 4-oxo-8-benzopyren-hemihydrate (ONO-1078, BH), a cysLT1 receptor antagonist to treatment of allergic rhinitis. MATERIALS AND METHOD: Sixty-five guinea pigs (GPs) were divided into 3 groups: 15 for the control group, 25 for sensitized GPs group and 25 for nonsensitized GPs group. Sensitized GPs were actively sensitized by intraperitoneal injection of 10 mug DNP-As containing 1 mL Al (OH)3 and booster injections were given intraperitoneally 2, 4 and 6 weeks after the initial immunization. Measurements of nasal volume were made by acoustic rhinometry. Also transmission electron microscopy was performed to investigate ultrastructural changes of the nasal mucosal membrane in the LTD4 administrated GPs and the BH treated GPs. RESULTS: Acoustic rhinometry revealed that the changes of nasal volume showed significant reduction at 30 minutes and 6 hours after instillation of LTD4 in nonsensitized guinea pigs (GPs). However, neither nonsensitized nor sensitized GPs with systemic administration of BH showed any changes in nasal patency. Many neutrophils and eosinophils were seen in perivascular space after local administration of LTD4 in control GPs. However there are no eosinophil infiltration into the subepithelial space in BH treated GPs in both nonsensitized and sensitized group. CONCLUSION: The results suggest that BH might be a potent LT receptor antagonist in the allergic model of GPs, which reduces nasal blockage and block chemotaxis of eosinophils to the mucous membrane of the nose.
Animals ; Chemotaxis ; Eosinophils ; Guinea Pigs* ; Guinea* ; Immunization ; Injections, Intraperitoneal ; Leukotriene Antagonists ; Leukotriene D4 ; Membranes ; Microscopy, Electron, Transmission ; Mucous Membrane* ; Nasal Obstruction ; Neutrophils ; Nose ; Receptors, Leukotriene* ; Rhinitis ; Rhinometry, Acoustic ; Sinusitis

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure

We report a case of metastatic renal cell carcinoma to thyroid. A 56-year-old woman was presented with multiple nodules in the thyroid with the history of left radical nephrectomy 4 years ago due to renal cell carcinoma(stage I). During postnephreectomy follow-up period, no recurrence nor metastasis to other organs were noted. She had euthyroid function and multiple cold nodules in bilateral lobes on thyroid scan. Total thyroidectomy was done, and multiple nodules in the thyroid were bilaterally. The pathology reports showed the findings of metastatic renal cell carcinoma to the thyroid. The postoperative course was uneventual.
Carcinoma, Renal Cell* ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Pathology ; Recurrence ; Thyroid Gland* ; Thyroidectomy