Risk Factors for Transurethral Coagulation for Hemostasis During Holmium Laser Enucleation of the Prostate / 대한배뇨장애요실금학회지

Purpose@#We aimed to identify risk factors for transurethral coagulation (TUC) using bipolar electrocautery for hemostasis during holmium laser enucleation of the prostate (HoLEP) surgery for benign prostatic hyperplasia (BPH). @*Methods@#We analyzed the clinical outcomes of HoLEP surgery performed by a single surgeon between January 2010 and April 2020 at the Seoul National University Hospital. Patient characteristics and perioperative parameters were used to identify the risk factors for TUC. The TUC group was defined as a case of conversion to hemostasis using electrocautery during the hemostasis step after enucleation. @*Results@#Of 1,563 patients, 357 underwent TUC (TUC group; 22.8%) as an adjuvant (n=299, 19.1%) or salvage (n=58, 3.7%) therapy. Patients in the TUC group were older (mean±standard deviation, 70.6±7.3 years vs. 69.3±7.0 years; P=0.002), had more 5-alpha reductase inhibitor (5-ARI) use (35.6% vs. 25.9%, P35 mL. Therefore, TUC may be potentially necessary in patients with a large transition zone volume in patients with BPH.

Improvement of Health Indicators after Participating in Health Promotion Program of General Hospital Staff: A Pilot Study

BACKGROUND@#An 8-week health program is achieved for health providers in a general hospital in Seoul to verify whether health parameters are enhanced by improving life habits. We want to examine the effect of this program with measuring health parameters and exercise ability. This study is performed as a pilot study, and the goal is to introduce the outcome of health program with experimental methods.@*METHODS@#Participants of this research consist of 42 health providers who were overweight, and they enrolled an 8-week health program in 2015. They took a class about improving eating habits and recorded daily diet. Moreover, they implemented exercise program with encouraging active participation by rewarding members who attended the program frequently.@*RESULTS@#The result is analyzed with 31 participants who finished the program. There are 4 men whose physical indices correspond with the criteria of metabolic syndrome. Otherwise, 27 women have physical indices below the criteria. The result indicates that physical indices would not reveal meaningful changes. However, basal fitness comprised of flexibility, sit-up, and back muscle strength implies meaningful improvement.@*CONCLUSIONS@#Even though there were some problems to revise in exercise intervention, it was accomplished systematically while nutrition intervention was not controlled strictly. In addition, factors including inspiring the enrollment of men and extending the period of program should be considered to improve the next program. The final goal of the health promoting hospital is to improve the health of health providers by sustaining this program with developing exercise and nutrition intervention in detail.

Improvement of Health Indicators after Participating in Health Promotion Program of General Hospital Staff: A Pilot Study

BACKGROUND: An 8-week health program is achieved for health providers in a general hospital in Seoul to verify whether health parameters are enhanced by improving life habits. We want to examine the effect of this program with measuring health parameters and exercise ability. This study is performed as a pilot study, and the goal is to introduce the outcome of health program with experimental methods. METHODS: Participants of this research consist of 42 health providers who were overweight, and they enrolled an 8-week health program in 2015. They took a class about improving eating habits and recorded daily diet. Moreover, they implemented exercise program with encouraging active participation by rewarding members who attended the program frequently. RESULTS: The result is analyzed with 31 participants who finished the program. There are 4 men whose physical indices correspond with the criteria of metabolic syndrome. Otherwise, 27 women have physical indices below the criteria. The result indicates that physical indices would not reveal meaningful changes. However, basal fitness comprised of flexibility, sit-up, and back muscle strength implies meaningful improvement. CONCLUSIONS: Even though there were some problems to revise in exercise intervention, it was accomplished systematically while nutrition intervention was not controlled strictly. In addition, factors including inspiring the enrollment of men and extending the period of program should be considered to improve the next program. The final goal of the health promoting hospital is to improve the health of health providers by sustaining this program with developing exercise and nutrition intervention in detail.

Methazolamide-induced toxic epidermal necrolysis confirmed by lymphocyte activation test

Among various dermatological entities, toxic epidermal necrolysis (TEN) is a rare but potentially fatal delayed hypersensitivity reaction to numerous medications. A 38-year-old male presented with systemic hypersensitivity reaction, such as high fever, pain in the eyes, and diffuse pruritic erythematous maculopapular eruptions with multiple targetoid plaques that became vesicular and bullous. Oral mucosa and conjunctivae were involved. The first sign appeared about 1 week after taking methazolamide (50 mg twice a day) for the management of glaucomatous eyes. Although methazolamide was discontinued, blistering and skin denudation progressed to affect up to 80% of the body surface area and a positive Nikolsky sign was noted. High fever also persisted. Skin lesions started to improve after 2 weeks of management and fever subsided. Cutaneous lesions improved with minimal permanent sequele 2 months later. HLA-B*5901 was found by high-resolution genotyping. The lymphocyte activation test performed 6 months after remission showed a positive response to methazolamide challenge. This is the first case of methazolamide-induced TEN in which methazolamide was confirmed as a culprit drug by the lymphocyte activation test.

Radiological anatomical consideration of conjoined nerve root with a case review / 대한해부학회지

Nerve root anomalies are frequently underrecognized regardless of the advances in imaging studies; they are also underappreciated and underreported when encountered surgically. The classification of conjoined nerve roots is based on whether the nerve root emerges at an abnormal level or from an anastomotic branch. In the present report, we describe case with a conjoined nerve root that emerged at a more caudal level than that normally observed that was an undiagnosed on preoperative imaging studies. We also discuss the atypical imaging features obtained through preoperative imaging studies. As observed in the present case, preoperative recognition and diagnosis of such anomalies offer the best opportunity of performing a successful procedure and preventing inadvertent damage to nerve roots intraoperatively.

A Case of Interstitial Pneumonitis and Pancytopenia Following the Combination Therapy of Pegylated Interferon and Ribavirin / 결핵및호흡기질환

The combination therapy of pegylated interferon and ribavirin is the mainstay of treatment for chronic hepatitis C patients. Anti-viral therapy is commonly associated with side effects such as headache, fever, myalgia, and arthralgia. However, anti-viral therapy can continue because these side effects are mostly mild and can be improved with supportive management. Anti-viral therapy should be stopped promptly if serious side effects, such as interstitial pneumonitis or hemolytic anemia occur, although those serious side effects are rare. There were a few case reports of interferon-related interstitial pneumonitis worldwide. In Korea, one atypical case report of interstitial pneumonitis has been reported, which followed the combination therapy of interferon-alpha and ribavirin in a patient with chronic hepatitis C. We present a case of interstitial pneumonitis and pancytopenia following the combination therapy of pegylated interferon and ribavirin in a patient with chronic hepatitis C.

A Case of Interstitial Pneumonitis and Pancytopenia Following the Combination Therapy of Pegylated Interferon and Ribavirin / 결핵및호흡기질환

The combination therapy of pegylated interferon and ribavirin is the mainstay of treatment for chronic hepatitis C patients. Anti-viral therapy is commonly associated with side effects such as headache, fever, myalgia, and arthralgia. However, anti-viral therapy can continue because these side effects are mostly mild and can be improved with supportive management. Anti-viral therapy should be stopped promptly if serious side effects, such as interstitial pneumonitis or hemolytic anemia occur, although those serious side effects are rare. There were a few case reports of interferon-related interstitial pneumonitis worldwide. In Korea, one atypical case report of interstitial pneumonitis has been reported, which followed the combination therapy of interferon-alpha and ribavirin in a patient with chronic hepatitis C. We present a case of interstitial pneumonitis and pancytopenia following the combination therapy of pegylated interferon and ribavirin in a patient with chronic hepatitis C.

Association of Exercise-Induced Asthma with Atopy in Adult Patients with Asthma-Like Symptoms / 대한내과학회지

BACKGROUND/AIMS: Atopy is closely related to asthma and is a risk factor for the development and exacerbation of asthma. The aim of this study was to evaluate the association between exercise-induced asthma (EIA) and atopy in adult patients with asthma-like symptoms. METHODS: Forty young male patients with asthma-like symptoms were enrolled. Skin prick, methacholine bronchial provocation, and exercise provocation tests were performed. Current and ex-smokers were excluded. RESULTS: Exercise provocation tests were positive in 21 patients (52.5%). Airway hyperresponsiveness (AHR) to methacholine (85.7% vs. 42.1%, p = 0.007) and atopy (85.7% vs. 47.4, p = 0.017) was found more frequently in patients with EIA than in those without EIA. EIA was significantly associated with atopy score (16.5 +/- 3.0 vs. 6.5 +/- 2.0, p = 0.011), atopy index (2.1 +/- 0.3 vs. 1.0 +/- 0.3, p = 0.004), and positive responses to Dermatophagoides pteronyssinus (76.2% vs. 42.1%, p = 0.028) and Dermatophagoides farinae (76.2% vs. 36.8%, p = 0.012), but not with positive responses to pollen allergens. AHR to methacholine (odds ratio [OR]: 14.3, 95% confidence interval [CI]: 1.86-109.4) and atopy (OR: 16.9, 95% CI: 2.04-140.74) were significant risk factors for EIA. CONCLUSIONS: Atopy was a risk factor for EIA in young adult men, and sensitization to house dust mites was associated with EIA.

Association of Exercise-Induced Asthma with Atopy in Adult Patients with Asthma-Like Symptoms / 대한내과학회지

BACKGROUND/AIMS: Atopy is closely related to asthma and is a risk factor for the development and exacerbation of asthma. The aim of this study was to evaluate the association between exercise-induced asthma (EIA) and atopy in adult patients with asthma-like symptoms. METHODS: Forty young male patients with asthma-like symptoms were enrolled. Skin prick, methacholine bronchial provocation, and exercise provocation tests were performed. Current and ex-smokers were excluded. RESULTS: Exercise provocation tests were positive in 21 patients (52.5%). Airway hyperresponsiveness (AHR) to methacholine (85.7% vs. 42.1%, p = 0.007) and atopy (85.7% vs. 47.4, p = 0.017) was found more frequently in patients with EIA than in those without EIA. EIA was significantly associated with atopy score (16.5 +/- 3.0 vs. 6.5 +/- 2.0, p = 0.011), atopy index (2.1 +/- 0.3 vs. 1.0 +/- 0.3, p = 0.004), and positive responses to Dermatophagoides pteronyssinus (76.2% vs. 42.1%, p = 0.028) and Dermatophagoides farinae (76.2% vs. 36.8%, p = 0.012), but not with positive responses to pollen allergens. AHR to methacholine (odds ratio [OR]: 14.3, 95% confidence interval [CI]: 1.86-109.4) and atopy (OR: 16.9, 95% CI: 2.04-140.74) were significant risk factors for EIA. CONCLUSIONS: Atopy was a risk factor for EIA in young adult men, and sensitization to house dust mites was associated with EIA.

Cervical Spinal Metastasis of Merkel Cell Carcinoma

Merkel cell carcinoma is a skin disease that rarely involves the spine. The common presentation of spinal involvement is quite confusing and may be easily misdiagnosed. However, once it spreads, the disease progresses rapidly, with an extremely poor outcome. We report on the case of a 30-year-old male with cervical spinal metastasis of Merkel cell carcinoma causing quadriparesis.

Remote Cerebellar Hemorrhage Complicated after Supratentorial Surgery: Retrospective Study with Review of Articles

OBJECTIVE: Remote cerebellar hemorrhage (RCH) is one of the rare complications occurring after supratentorial surgery, and its pathomechanism is poorly understood. We report 10 cases of RCH from our institution and review 154 cases from a database in order to delineate incidence, common presentation, risk factors, and outcomes of this complication. In addition, the means of prevention are discussed. METHODS: We reviewed the medical records of 10 patients who experienced RCH after undergoing supratentorial surgery at our institution between 2001 and 2008. A database search in Medline revealed 154 cases of RCH in the English literature. Characteristic features were analyzed and compared. RESULTS: There were 10 cases of RCH among 3307 supratentorial surgery cases, indicating a 0.3% incidence. All patients had characteristic imaging features of RCH, namely a streaky bleeding pattern in the superior folia of the cerebellum. Seven patients had a history of preoperative hypertension. Four cases were related to cerebral aneurysms, and other four developed after the removal of brain tumors. Cerebrospinal fluid (CSF) drainage apparatuses were installed postoperatively in all cases. Outcomes according to modified Rankin scale (mRS) were good in 7 patients, with 1 fatal case. CONCLUSION: RCH is a rare complication after supratentorial surgery, and the exact etiology still remains uncertain. Hypertension and perioperative loss of CSF seem positively correlated with RCH, but no single risk factor is totally responsible. Patients with RCH should be closely observed to improve their prognosis.

Repression of TNF-alpha-induced IL-8 expression by the glucocorticoid receptor-beta involves inhibition of histone H4 acetylation

Increased expression of a number of proinflammatory genes, including IL-8, is associated with inflammatory conditions such as asthma. Glucocorticoid receptor (GR)beta, one of the GR isoforms, has been suggested to be upregulated in asthma associated with glucocorticoid insensitivity and to work as a dominant negative inhibitor of wild type GRalpha. However, recent data suggest that GRbeta is not a dominant negative inhibitor of GRalpha in the transrepressive process and has its own functional role. We investigated the functional role of GRbeta expression in the suppressive effect of glucocorticoids on tumor necrosis factor (TNF)-alpha-induced IL-8 release in an airway epithelial cell line. GRbeta expression was induced by treatment of epithelial cells with either dexamethasone or TNF-alpha. GRbeta was able to inhibit glucocorticoid-induced transcriptional activation mediated by binding to glucocorticoid response elements (GREs). The suppressive effect of dexamethasone on TNF-alpha-induced IL-8 transcription was not affected by GRbeta overexpression, rather GRbeta had its own weak suppressive activity on TNF-alpha-induced IL-8 expression. Overall histone deacetylase activity and histone acetyltransferase activity were not changed by GRbeta overexpression, but TNF-alpha-induced histone H4 acetylation at the IL-8 promoter was decreased with GRbeta overexpression. This study suggests that GRbeta overexpression does not affect glucocorticoid-induced suppression of IL-8 expression in airway epithelial cells and GRbeta induces its own histone deacetylase activity around IL-8 promoter site.

Repression of TNF-alpha-induced IL-8 expression by the glucocorticoid receptor-beta involves inhibition of histone H4 acetylation

Increased expression of a number of proinflammatory genes, including IL-8, is associated with inflammatory conditions such as asthma. Glucocorticoid receptor (GR)beta, one of the GR isoforms, has been suggested to be upregulated in asthma associated with glucocorticoid insensitivity and to work as a dominant negative inhibitor of wild type GRalpha. However, recent data suggest that GRbeta is not a dominant negative inhibitor of GRalpha in the transrepressive process and has its own functional role. We investigated the functional role of GRbeta expression in the suppressive effect of glucocorticoids on tumor necrosis factor (TNF)-alpha-induced IL-8 release in an airway epithelial cell line. GRbeta expression was induced by treatment of epithelial cells with either dexamethasone or TNF-alpha. GRbeta was able to inhibit glucocorticoid-induced transcriptional activation mediated by binding to glucocorticoid response elements (GREs). The suppressive effect of dexamethasone on TNF-alpha-induced IL-8 transcription was not affected by GRbeta overexpression, rather GRbeta had its own weak suppressive activity on TNF-alpha-induced IL-8 expression. Overall histone deacetylase activity and histone acetyltransferase activity were not changed by GRbeta overexpression, but TNF-alpha-induced histone H4 acetylation at the IL-8 promoter was decreased with GRbeta overexpression. This study suggests that GRbeta overexpression does not affect glucocorticoid-induced suppression of IL-8 expression in airway epithelial cells and GRbeta induces its own histone deacetylase activity around IL-8 promoter site.

Macrophage Depletion by Clodronate Liposomes Suppresses Neointimal Formation After Carotid Artery Injury in Apolipoprotein E-Deficient Mice

BACKGROUND AND OBJECTIVES: Clodronate liposomes deplete phagocytic cells, thereby suppressing inflammation after vascular injury. We compared the effect of clodronate liposomes on macrophage depletion and neointimal formation in apolipoprotein E-deficient mice [ApoE (-) mice]. MATERIALS AND METHODS: ApoE (-) mice were randomly assigned to the clodronate liposomes group (Clodronate Group, n=7) and the vehicle liposomes group (Control Group, n=7). Clodronate (0.1 mL/10 g) was injected via the tail vein starting 2 days (d-2) before left common carotid artery injury. RESULTS: The percentage of blood monocytes was subsequently decreased after clodronate injection (14.0+/-7.4% at baseline, 6.8+/-4.9% at 24 hours and 0.7+/-0.3% at 1 week after the clodronate liposome injection). The percentage of macrophages in the plaque area was significantly lower in the clodronate group at week 2 (32.0+/-6.5 vs. 68.7+/-7.6%, respectively, p<0.05) and at week 4 (37.3+/-8.5 vs. 62.6+/-9.4%, respectively, p<0.05). The interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha concentrations were significantly decreased in the clodronate group at week 4 (12.3+/-2.5 vs. 22.9+/-3.5 pg/mL, respectively, p<0.05 for IL-6 and 16.6+/-2.2 vs. 43.6+/-6.1 pg/mL, respectively, p<0.05 for TNF-alpha). The plaque volume was significantly greater in the control group at week 2 (0.345+/-0.063 vs. 0.153+/-0.053 mm2, respectively, p<0.05) and at week 4 (0.320+/-0.027 vs. 0.167+/-0.070 mm2, respectively, p<0.05). CONCLUSION: Intravenous administration of clodronate liposomes depleted monocytes and macrophages, and so this reduced the inflammatory markers and neointimal formation in ApoE (-) mice.

The prevalence of adverse drug reactions to a short course anti-tuberculosis regimen / 대한내과학회지

BACKGROUND: Anti-tuberculosis drugs used in combination cause adverse drug reactions, but the prevalence of the reactions and risk factors have not been determined. This study aims to identify the prevalence and risk factors of adverse drug reactions (ADR) to the use of first line anti-tuberculosis drugs. METHODS: A total of 435 newly diagnosed patients with tuberculosis (44.1 years+/-19.0 years) were eligible for this study. All patients received daily oral isoniazid (300 or 400 mg), rifampicin (450 or 600 mg) and ethambutol (800 mg) for 6 months, and pyrazinamide (20 mg/kg) for 2 months. Blood tests were performed regularly (before treatment, 2 weeks after treatment, and bimonthly there after). Patients were interviewed 2 months and 6 months after treatment. A serious ADR was defined as any ADR that resulted in the discontinuation of one or more of the drugs. RESULTS: An ADR was noted in 52.6% of all patients. Gastrointestinal (19.3%), cutaneous (17.7%), hepatic (13.8%), renal (12.6%), and neurological (10.3%) ADRs were frequent and hematological (4.4%), musculoskeletal (3.0%) ADRs were less frequent. A skin ADR was associated with an elevated baseline of liver enzymes (odds ratio, 3.48; 95% CI, 1.2 to 9.9), whereas a hepatic ADR was associated with a history of chronic liver disease (odds ratio, 4.82; 95% CI, 1.7 to 13.2). The prevalence of any serious ADR was 9.7%. Occurrence of any serious ADR was associated with a history of chronic liver disease (odds ratio, 4.29; 95% CI, 1.4 to 13.6). CONCLUSIONS: Anti-tuberculosis drugs given in combination frequently caused a ADR and the findings suggest that a patient receiving anti-tuberculosis treatment should be closely monitored.

Effect of GRbeta expression on steroid-induced transcriptional activity in airway epithelial cells / 천식및알레르기

BACKGROUND: It has been known that GRbeta(90 kDa), an alternative splicing variant, can not bind ligand and may act as a domiant negative inhibitor of GRalpha. But there is little report on the effect of GRbeta on steroid-induced transrepression, and GRbeta as a dominant negative inhibitor is still uncertain. OBJECTIVE: The aim of this study is to investigate the functional role of GRbeta expression in steroid-induced transcriptional activity. METHODS: Steroid-induced transactivation was measured by using pGRE luciferase reporter gene in A549 cell line and steroid-induced transrepression was measured by using stable A549 IgGkappa-NFkappaB luciferase cell line, which contained the minimal IL-8 promoter region. Effect of GRbeta expression on steroid-induced transactivation or transrepression were investigated by comparing the results with or without pCMV GRbeta transfection by lipopectamine plus method. TNF-alpha was used as an activator of IL-8 and RU486 was used as a steroid antagonist. RESULTS: GRbeta expression inhibited steroid-induced transactivation, but did not inhibit steroid-induced transrepression. GRbeta expression caused transrepression of IL-8 under the pretreatment of RU486. CONCLUSION: The study suggests that GRbeta may not act as a dominant negative inhibitor of GRalpha, in the steroid-induced transrepression. Furthermore GRbeta looks having a suppressive activity on IL-8 transactivation.

Expression of mRNA of GATA-3 and T-bet in the peripheral blood mononuclear cells of atopic asthmatics / 대한내과학회지

BACKGROUND: It is well known that the expression of Th2 cytokines are up-regulated in the atopic asthma. The study was to investigate the expression of transcription factors, such as GATA-3, c-maf, T-bet which are known to be involved in the T cell differentiation in the peripheral blood mononuclear cells (PBMCs) of atopic asthmatics. METHODS: PBMCs were obtained from non-atopic controls and atopic asthmatics and cultured for 48 hours, and then 12-o-tetracanoylphorbol-13-acetate (PMA) and calcium ionophore (ionomycin) were added. mRNA of GATA-3, c-maf, T-bet, IL-4, IL-5, IL-13 and IFN-gamma were measured by RT-PCR RESULTS: mRNAs of Th2 cytokines, such as IL-4, IL-5 and IL-13 were expressed higher in the atopic asthmatics, and that of Th1 cytokine, IFN-gamma was expressed higher in the non-atopic controls. GATA-3 and c-maf were expressed higher and T-bet was expressed lower in the atopic asthmatics. Expressions of GATA-3, c-maf and T-bet were not changed with the stimulation of PMA/Ionomycin. CONCLUSION: This study suggest that GATA-3, c-maf and T-bet participate in the Th2 type inflammation in atopic asthmatics, like GATA-3 and c-maf as stimulatory factors, and T-bet as inhibitory factor.

A Case Report of Neurilemmoma of the Chest Wall / 결핵

Benign solitary schwannoma of the chest wall is a rare disease of nerve sheath origin A 43-year-old female patient was admitted to our hospital for right upper quandrant pain Chest X-ray shows nonspecific finding, ultrasonography & CT scan revealed a solid tumor on the right lateral chest wall. On aspiration needle biopsy, this mass was turned out to be a schwannoma of the right lateral chest wall. This mass was excised surgically in an encapsulated state by right lateral thoracotomy. Histological section revealed a typical schwannoma, which is characterized by Antoni A and Antoni B tissues of high & low cellularity.

A case of Tetranychus urticae - induced asthma in an inhabitant around pear orchard / 천식및알레르기

There have been a few reports of occupational asthma caused by Tetranychus urticae in fruit farmers or greenhouse workers. We report a case of bronchial asthma induced by Tetranychus urticae from a pear orchard in Cheonan city. An 18-year-old female student living around a pear orchard suffered from intermittent cough, rhinorrhea, and dyspnea for the 3 years. Her PC20 -methacholine was 0.15mg/ml, and skin prick test done with 55 inhalant allergens showed negative responses except Tetranychus urticae extract which was prepared with highly parasitized pear leaves. Bronchial provocation test with Tetranychus urticae extract showed a dual asthmatic response. These findings indicate that Tetranychus urticae, which include parasites in fruit trees, herba,ceous plants, and greenhouse cultures, can cause IgE-mediated bronchoconstriction in Korea.

The Role of Protein Kinase C and Protein Tyrosine Kinase in the Signal Transduction Pathway of stimulus Induced by Endotoxin in Peripheral Blood Monocyte / 결핵

BACKGROUND: Endotoxin, the component of outermembrane of gram negative organism, plays an important role in the initiation and amplification of inflammatory reaction by its effects on inflammatory cells. Until recently, there have been continuing efforts to delinate the mechanisms of the signal trasduction pathway of endotoxin stimuli on inflammatory cells. By uncovering the mechanisms of signal transduction pathway of endotoxin stimuli, we can expect to have tools to control the excessive inflammatory responses which sometimes may be fatal to the involved host. It was generally accepted that endotoxin exerts its inflammatory effects through inflammatory cytokines that are produced by endotoxin-stimulated inflammatory cells and there were some reports on the importance of protein kinase C and protein tyrosine kinase activation in the production of inflammatory cytokines by endotoxin. So we evaluated the effect of pretreatment of protein kinase C inhibitors (H7, Staurosporin) and protein tyrosine kinase inhibitors(Herbimycin, Genistein) on the endotoxin-stimulated cytokines(IL-8 & TNF-alpha) mRNA expression. METHOD: Peripheral blood monocytes were isolated from healthy volunteers by Ficoll-Hypaque density gradient method and purified by adhesion to 60mm Petri dishes. Endotoxin(LPS 100ng/ml) was added to each dishes except one control dish, and each endotoxin-stimulated dishes was preincubated with H7, Staurosporin(protein kinase C inhibitor), Herbimycin or Genistein(protein tyrosine kinase inhibitor) respectively except one dish. Four hours later the endotoxin stimulation, total RNA was extracted and Northern blot analysis for IL-8 mRNA and TNF-alpha mRNA was done. RESULT: Endotoxin stimulation increased the expression of IL-8 mRNA and TNF-alpha mRNA expression in human peripheral blood monocyte as expected and the stimulatory effect of endotoxin on TNF-alpha mRNA expression was inhibited by protein kinase C inhibitors(H7, Staurosporin) and protein tyrosine kinase inhibitors (Herbimycin, Genistein). The inhibitory effect of each drugs was increased with increasing concentration. The stimulatory effect of endotoxin on IL-8 mRNA was also inhibited by H7 and protein tyrosine kinase inhibitors (Herbimycin, Genistein) dose-dependently but not by Staurosporin. CONCLUSION: Protein kinase C and protein tyrosine kinase are involved in the endotoxin induced signal transduction pathway in human peripheral blood monocyte.