The Antiapoptotic Effect of Vascular Endothelial Growth Factor and Angiopoietin-1 on Glomerular Endothelial Cells in Adriamycin or Cisplatin-induced Apoptosis / 대한신장학회잡지

BACKGROUND: Because glomerular endothelium play a pivotal role in the renal diseases, damage of glomerular endothelial cells lead to progression of glomerular sclerosis and decrement of renal function. Apoptotic damage of cells is an important mechanism in renal disease. Therefore, several growth factors that have antiapoptotic effect may have a protective role in maintaining a renal function in apoptotic cell injury. METHODS: The present study evaluated whether cisplatin or adriamycin induce apoptosis in glomerular endothelial cells. We also evaluated the antiapoptotic effect of angiopoietin-1 and VEGF in cisplatin or adriamycin- induced apoptosis. RESULTS: Cisplatin or adriamycin induced apoptosis in glomerualr endothelial cell in dose dependent manner. Angiopoietin-1 and VEGF produced antiapoptotic effect in cisplatin or adriamycin-induced apoptosis in a dose dependent manner. The antiapoptotic effect of angiopoietin-1 was more potent than that of VEGF in glomerualr endothelial cells. Wortmannin, a phosphatidylinositol 3'-kinase inhibitor decrease the angiopoietin-1 or VEGF-induced antiapoptotic effect. CONCLUSION: These results suggest that angiopoietin-1 and VEGF may be a strong survival factor for the glomerular endothelial cells in the cisplatin or adriamycin-induced apoptosis through phosphatidylinositol 3'-kinase/Akt. Therefore, pretreatment of angiopoietin-1 and VEGF could play a beneficial role for maintaining normal glomerular endothelial cell integrity before and during systemic cisplatin or adriamycin therapy.

A Case of Benign Intracranial Hypertension (Pseudotumor cerebri) Associated with Systemic Lupus Erythematosus / 대한혈액학회지

Benign intracranial hypertension (BIH) is very rare and its cause is unclear. Raised intracranial pressure in the absence of an intracranial mass or hydrocephalus (BIH or pseudotumor cerebri) has been described in association with many conditions including SLE. Several pathogenic pathways tie BIH with SLE as thrombotic obliteration of cerebral arteriolar and venous systems and immune complex deposition within the arachnoid villi that are responsible for cerebrospinal fluid (CSF) absorption. The diagnosis of BIH was confirmed by increased intracranial pressure in the absence of any abnormal radiological findings of the brain. We report a young woman with SLE and autoimmune thrombocytopenia complicated by BIH which resolved with corticosteroid therapy and osmotic diuretics.

Leukapheresis with high dose hydroxyurea in the management of lower leg artery obstruction in Chronic Myelogenous Leukemia / 대한내과학회지

There was no specific criteria of white cell count to determine the therapy of hyperleukocytosis in chronic myelogenous leukemia (CML). Therapeutic leukapheresis usually indicated in acute myelogenous leukemia with over 100,000/mm3 of white blood cell, leukocyte infiltration and leukostasis with over 100,000/mm3 of white blood cell, and hairy cell leukemia with no response to drug and splenectomy. Leukapheresis can reverse the hyperleukocytic syndrome rapidly, be used immediately without having to wait for the result of allopurinol to reduce the risk of uric acid nephropathy and decrease the tumor cell mass so as to minimize the extent of cytolysis- induced hyperuricemia, hyperkalemia and hyperphosphatemia. We report a case of 56-year-old man presented right lower leg pain, gait disturbance who was diagnosed CML 4 years before. He showed right popliteal artery obstruction in doppler sonogram and immediatly started leukapheresis. After two therapeutic leukapheresis, symptoms were improved and popliteal blood flow was improved by follow-up doppler sonogram. As a result, we consider that leukapheresis without use of anticoagulant or thrombolytic agents is effective therapy in CML associated leukocytosis and vascular obstruction.

A Case of Tracheal Leiomyoma / 대한내과학회지

Leiomyomas account for 2% of the benign tumors of the lower tracheobronchial tree. Tracheal leiomyomas most commonly occur in the fourth decade man. The most co mmon segment to be affected is the lower third of the trachea and the usual site of origin is the posterior mem branous portion. Symptoms are due to partial or com plete obstruction of the trachea. Intermittent or constant dyspnea and wheezing are the most common symptoms of tracheal leiomyoma and have been erroneously ascri bed to bronchial asthma. Clinical symptoms distinguished from bronchial asthma, chest CT scan and bronchoscopy can make diagnosis. The diagnosis of leiomyoma of the lower respiratory tract is by chest C-T scan and bronc hoscopy, which gives direct visualization and biopsy ma terial is sent for histologic examination. The treatment of leiomyoma is essentially conservative since there have been no reports of recurrence after limited resection. Intr atracheal leiomyomas have been dealt with in three ways: by bronchoscopic removal, by excision via a tra cheotomy, and by circumferential resection with primary end-to-end anastomosis. In recent years, successful mass removal with YAG laser and electrocautery technique were reported. We have experienced 36 year-old-male with hemopty sis, cough and sputum production. Tracheal leiomyoma was diagnosed by chest CT scan and bronchoscopy. Mass removal and tracheoplasty were done successfully. So we present this case with the review of literature.

Quantitative Rapid Urease Test in Helicobacter Pylori Infection / 대한소화기내시경학회지

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.

A case of accessory tracheal bronchus in patient with bronchial asthma / 알레르기

Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal bronchial wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. Its incidence ranges from 0.1 to 5%. This anomaly is usually diagnosed incidentally during bronchoscopy or bronchography in patients with various respiratory problems. Tracheal bronchus may be associated with other bronchopulmonary anomalies such as tracheal stenosis, pulmonary agenesis, pulmonary sequestration, abnormal lobulation, and Down's syndrome. In patients without specific clinical symptoms, a incidentally diagnosed tracheal bronchus does not require any treatment. We report a case of 59-year-old man incidentally detected accessory tracheal bronchus associated with bronchial asthma with review of literatures.

A Case Report of Myxoma in the Lung / 결핵

Since Virchow first introduced the term myxoma to describe a tumor that recapitulates the structure of the umbilical cord, it has been increasingly recognized that many diverse neoplasms may acquire a similar myxoid appearance. Myxoma have evolved within the pathology literature from tumors often described in practically all sites to the currently recognized subtypes restricted to the heart, skin, soft tissue, and bone. Pulmonary myxoma is extraordinary rare. We experienced pulmonary myxoma in a 63 year old man. The pulmonary radiology showed mass in right upper lung field, and percutaneous transthoracic needle lung biopsy was performed to confirm the myxoma.

A Case of Focal Nodular Hyperplasia of the Liver / 대한간학회지

Focal nodular hyperplasia (FNH) is a rare, benign hepatic tumor which was usually discovered incidentally by imaging procedure performed for some other reasons. FNH is typically asymptomatic and, it seldom bleeds. There is no evidence to support any relation with primary liver cancer. Accordingly, the preferred management is conservative, and excision is reserved for large symptomatic and complicated lesion, or when the diagnosis remains uncertain. Although many cases of FNH has been described to date in the other countries, only four cases of FNH has been reported in Korean literature. In the present report we describe a 7 cm sized asymptomatic lesion of FNH in a 23-year-old woman, that was disclosed by various kinds of imaging procedure. The left lateral segmentectomy was performed. The mass was firm and showed areas of localized growth of mature hepatocytes and septal fibrosis accompanied with marginal ductal proliferation, consistent with FNH. It also displayed an incomplete stellate architectual configration consisted of a central fibrous scar.