Effect of High Glucose, Angiotensin ll and Aniotenisn Converting Enzyme Inhibitor on the Expression of PC alpha1(IV) mRNA in Cultured Human Mesangial Cells / 대한신장학회잡지

OBJECTIVE: Diverse glomerular disorders leadsing to progressive glomerulosclerosis share the common features of increased mRNA expression for extra- cellular matrix protein and growth factors. The precise role of angiotensin II in contributing to these disturbances is currently unknown. ACE inhibitors have been proved to be beneficial in protecting against glomerular injury in animal models and many of human glomerular diseases. Type IV collagen is a main component of extracellular matrix in the mesangium : its increased accumulation is a common pathologic finding in the glomerulosclerosis. There are some evidences that the beneficial effect of ACE inhibitor does not solely depend on the hemodynamic effect, but may be mediated by other effect. The purpose of this study is to evaluate the effects of high glucose, angiotensin II and angiotensin converting enzyme inhibitor on the expression of PC alpha1(lV) in mesansial cells(MCs). METHODS: Human mesangial cells were cultured with standard method. To investigate the effect of each drug and high glucose condition, MCs were cultured in the normal-glucose medium(100mg/dl) and high-glucose medium(450mg/dl), respectively. An- giotensin II and angiotensin converting enzyme inhibitor(captopril) were added to culture medium at final concentration of 10 M which is the physiologic dose in vivo. MCs were cultured in each condition for 3days, when the maximal effect of high glucose on MCs, and harvested for mesurement of the expression of PC alpha1(IV) mRNA. To quantitate the PC alpha(1V) mRNA levels in each condition, semiquantitatine RT-PCR was done with co-amplification of house keeping gene. RESULTS: PCa1(IV) mRNA expression was significantly increased in high-glucose medium(30mM) compared to normal-glucose medium(5.5mM)(2.28+/-0.34 vs 0.96+/-0.08, p(IV) mRNA expression to 4.64+/-0.28(p<0.05). Angiotensin II in the normal-glucose medium increased the PC alpha1(lV) mHNA expression as 2.69+/-0.23 control(p<0.05). Addition of angiotensin converting enzyme inhibitor(Capopril, 10(-6)M) in high- glucose culture medium significantly suppressed the PC alpha1(IV) mRNA expression as 0.690.11(p<0.05). CONCLUSION: High glucose concentration in culture medium significantly increases the mRNA expression of procollagen alphal(IV) than normal glucose concentration. Angiotensin II increases the collagen mRNA expression directly and this effect was significantly prevented by ACE inhibitor. This result suggests that hyperglycemia in diabetic millieu can directly increase collagen production, and ACE inhibitor may inhibit progressive glomerulosclerosis by decreasing collagen production as well as reducing intraglomerular pressure.

A Case of Gastric Submucosal Tumors in Children Diagnosed by Endoscopic Ultrasonography / 대한소화기내시경학회지

Benign neoplasms of the stomach are uncommon in children. They include adenomatous and hyperplastic polpys, leiomyomas, lipomas, and other lesions. Gastric leiomyoma in childhood represent only 1% of all gastrointestinal neoplasms reported, and slightly more than half of these are gastric. The tumor arises in the muscle layer of the stomach and is usually intragastric and submucosal. Barium contrast studies are useful in localizing leiomyoma with significant intramural or submucosal growth. An endoscopy can permit histologic confirmation if the tumor has eroded through the mucosa. Differentiation however, of malignant lesions from benign submucosal leiomyomas may be difficult. Using endoscopic ultrasonund imaging, highly accurate gastrointestinal tumor characterization, especially submucosal masses, and differentiation of malignant from benign lesion are now relatively possible without surgery. We experienced a case of a gastric submucosal tumor regarded as a leiomyoma, which was diagnosed using endoscopic ultrasonography, and report the findings with a review of related literatures.

Apoptosis on Acute Cyclosporine Nephrotoxicity in Rat / 대한내과학회지

OBJECTIVES: Apoptosis is a physiologic or programmed cell death in contrast with necrotic cell death. Recently it has been known that apoptosis are concerned in the effects of chemotherapeutic agents or radiation therapy on tumor cells. Cyclosporine a(CsA), a potent immunosuppressant, has been effectively used in organ transplantaion, but it also has a significant toxicity in the kidneys. However the exact mechanism of CsA nephrotoxicity has not been ellucidated yet. This study was performed to investigate whether apoptosis particiates in CsA nephrotoxicity or not. METHODS: Twenty seven Sprague-Dawley rats were divided into 5 groups. 1) Vehicle group(n=7) as a control: Cremopbor 50mg/kg/day/subcutaneously (sc) for 7 days, 2) CsA4 group(n=5): CsA 50mg/kg/day/sc for 4 days, 3) CsA7 group(n=5): CsA 50mg/kg/day/sc for 7 days, 4) R4 group(n=5): 4 days after CsA 50mg/kg/day/se for 7 days, and 5) R8 group(n=5): 8 days after CsA 50mg/kg/day/sc for 6 days, Biochemical parameters including blood pressure were measured in each group and the cell count of apoptosis in rat kidney was evaluated by in situ end labelling(ISEL) method. RESULTS: 1) The increase of serum creatinine, blood pressure and decrease of creatinine clearance appeared in CsA4 and CsA7 groups. 2) The ce11 counts of apoptosis on tubular cells in CsA4 and CsA7 groups were significantly increased more than in control group(79.0 +/- 16.9, 98.4 +/- 11.4 vs 35.4 +/- 8.8, p0.05), 3) The cell count of apoptosis on the interstitium in each group was not significantly different from that in control group(p>0.05). 4) The cell count of apaptosis on tubular cells was increased more than that on the interstitium in all groups. 5) The cell count of apoptosis on cortex only in CsA7 group was significantly increased more than that io control group(57.8 +/- 11.5 vs 21.8 +/- 2.6, p<0.05), 6) The cell count of apoptosis on medulla only in CsA4 group was significantly increased more than that in control group(636. +/- 17.9 vs 22.6 +/- 9.7, p<0.05). 7) Total cell counts of apoptosis only in CsA4 and CsA7 groups were significantly increased more than in contral group(96.0 +/- 21.1, 99.8 +/- 11.8 vs 46.6 +/- 11.4, p<0.05). CONCLUSION: CsA caused apoptosis mainly on tubular cells rather than the interstitial cells and apoptotic cells in CsA nephrotoxicity were not increased during the recovery phase. With the results apoptosis may play an important role in CsA nephrotoxicity.

A Clinical Study of Surgical Results on 456 Blepharoptosis

We have performed surgical procedure in 456 patients(582 lids) with blepharoptosis. The surgical results were studied retrospectively according to age, sex, etiology, surgical methods, surgical results, and postoperative complications. Of all patients, male accounted for 58.6% and monocular ptosis(72.4%) occurred more often in the right eye(37.5%) than in left eye and binocular ptosis was found in 126 cases(27.6%) and most of ptosis proved to be congenital(92.3%) in origin. The 3~4mm group(63.9%) was the highest in the amount of blepharoptosis and the function of levator was most common in less than 4mm group(69.0%). The surgical results on cosmesls were obtained successfully in 501 lids(86.1%). The postoperative complications were undercorrection(11.7%) that was most frequent, and followed by overcorrection(3.5%), exposure keratitis(3.3%), poor lid contour(2.6%), Infection(1.2%) and others(0.5%).

Clinical Study Conjunctivodacryocystorhinostomy with Jones Tube

Conjunctivodacryocystorhinostomy(CDCR) with Jones tube is indicated in the cases with upper and lower or common canaliculi obstruction or failed cases of dacryocystorhinostomy. We made a clinical evaluation of the 247 CDCR with Jones tube which had been performed from May of April of 1990. The results were as follows: 1. Canalicular obstruction occured mainly in economic age. 2. The most common cause of the canalicular obstruction was trauma involving canaliculi. 3. The overall success rate of CDCR with Jones tube was 96%. 4. The cases that needed reoperation were extrusion or loss of tube, tilting of tube anteriorly or superiorly, and being buried of Jones tube to nasal cavity in decending order of frequency. 5. Postoperative complications were obstruction of tube with mucoid discharge, granuloma formation, clogging of tube with conjungvtiva, and inflammation around the tube in decending order of frequency. 6. By the development of surgical technique, amount of intraoperative blood loss has been decreased and the duration operation time has become shortened.