Expression of Vascular Endothelial Growth Factor (VEGF) and Microvessel Density in Hepatocellular Carcinoma / 한국간담췌외과학회지

BACKGROUND/AIMS: Hepatocellular carcinoma is a typical hypervascular tumor. Growth of tumor and their metastases are dependent on factors that stimulate vessel formation (angiogenesis). Vascular endothelial growth factor (VEGF) has been reported to play an important role in angiogenesis in hepatocellular carcinoma. The present study examined VEGF expression immunohistochemically in hepatocellular carcinoma in clinicopathological prognostic factors. METHODS: We examined the VEGF expression and microvessel density in specimens surgically removed from 37 HCC patients by immunohistochemical methods. RESULTS: The expression rate on VEGF was 43.2% in tumor cells. The degree of VEGF expression was significantly correlated with cumurative survival rate (p=0.034). But the degree of VEGF expression did not correlate with any clinicopathological characteristics (p.0.05). VEGF expression demonstrated no correlation with microvessel density (p=0.064). CONCLUSIONS: Our findings suggest that VEGF expression can be useful prognostic factor (survival rate) of hepatocellular carcinoma.

Acute Renal Failure Associated with a Minimal Change Nephrotic Syndrome in a Systemic Lupus Erythematosus Patient

In systemic lupus erythematosus (SLE), acute renal failure (ARF) is usually associated with severe lupus nephritis and ARF associated with other glomerular diseases is extremely rare. We recently encountered a patient with ARF that was associated with a minimal change nephrotic syndrome (MCNS) in SLE. A 41-year-old woman presented with a nephrotic syndrome and ARF. She fulfilled four of the American College of Rheumatology criteria for the classification of SLE. However, a renal biopsy revealed that there were no glomerular abnormalities and no deposition of immune complex. The generalized edema disappeared and the high creatinine levels decreased after prednisolone therapy.

The frequency of thiamine deficiency in chronic alcoholics and in patients at a long-term care facility / 대한내과학회지

BACKGROUND: As socioeconomic status has improved, malnutrition has become rare in Korea and generally it is no longer considered as a serious problem in medical practice. However, contrary to the above general belief we managed four patients with beriberi in 1999 and it became apparent that malnutrition might remain a problem in certain groups of patients. In this study, we assessed the nutritional state, especially with respect to thiamine deficiency, in chronic alcoholics and in patients residing at a long-term care facility (LTCF). METHODS: Fourteen chronic alcoholic patients and twenty patients being hospitalized in a long-term care facility were assigned as the study groups. The subjects' mean ages and standard deviations were 48.9+/-10.2 and 50.6+/-6.7, respectively. Medical records were reviewed to determine other aspects of their nutritional status and their dietary patterns. Ten peoples who visited the health promotion center at Inha University Hospital, for routine check-ups were allocated to the control group. Blood total thiamine levels were measured by high-performance liquid chromatography. RESULTS: Body mass indices were significantly lower in chronic alcoholics and in patients at the LTCF than in the control group (p=0.0065). Serum albumin levels were within the reference range in all three groups, but were significantly lower in patients at the LTCF than in the control group (p=0.0013). Moreover, no difference was detected between the alcoholic group and the control group in terms of thiamine levels. However, the mean thiamine level in patients at the LTCF was statistically lower than that of the control group and four (20%) patients in the LTCF group showed subnormal blood thiamine levels. The thiamine level tended to decrease with age in both alcoholics and patients at the LTCF. No correlation was found between thiamine level and the other variables examined, namely, hospital stay, body mass index, and serum albumin level. CONCLUSION: A considerable portion of patients in a long term care facility showed thiamine deficiency, however, no evidence of thiamine deficiency was found among alcoholics. This result suggests that thiamine deficiency in patients at long-term care facility may be more prevalent and that thiamine supplementation may be warranted, especially for those with other thiamine deficiency risk factors.

The Prevalence of Bartonella henselae Infection in Korean Feral Cats / 감염

BACKGROUND: Cat scratch disease (CSD) is an emerging disease worldwide and is mainly caused by Bartonella henselae, a gram-negative bacterium. The most common clinical manifestation is regional lymphadenopathy, though clinical recognition may be difficult, as atypical manifestations occur. The condition can be complicated by neuroretinitis, endocarditis, and sometimes fatal encephalopathy. The reservoir of B. henselae is the cat, and the prevalence rates of B. henselae infection in cat populations range from 4 to 70%. The prevalence of Bartonella infection in Korea has not been studied, thus, in this study Bartonella infection was investigated in cats captured in the Inchon and Ansan areas. METHODS: Twenty wild cats were captured and their livers and spleens were examined by polymerase chain reaction (PCR), bacterial culture, and histopathologically. PCR used two primers: Cat (sense:5'-GAT TCA ATT GGT TTG AA(G/A) GAG GCT-3', antisense:5'-TCA CAT CAC CAG G(A/G)C GTA TTC- 3') and Barto (sense:5'-(C/T) CT TCG TTT CTC TTT CTT CA-3', antisense:5'-AAC CAA CTG AGC TAC AAG CC-3'). Culture was performed by inoculating sliced spleen and liver into the ECV304 cell line and bacterial growth was observed over a period of 3 weeks. If no visible bacterial growth was identified, the presence of bartonella was examined by DNA staining, indirect immunofluorescent staining, and PCR. Liver and spleen were stained with H&E and scrutinized under the light microscope. RESULTS: Nine pairs of culture cells inoculated with liver and spleen were examined by indirect immunofluorescent staining and PCR; no positive case was found. In addition, no positive case was identified by PCR in the liver and spleen specimens of eleven cats. Spleen and liver specimens of eleven cats were examined by light microscopy and none showed granuloma. CONCLUSION: This preliminary study suggests that the Bartonella infection is probably uncommon in the cat population of the Inchon and Ansan areas. Further studies should be undertaken to detail the prevalence of Bartonella infection in other areas and in human.

Prediction of Post-operative Cardiopulmonary function By Perfusion Scan / 결핵

BACKGROUND: Perfusion scans are accurate predictors of postoperative lung function. There are few previous studies aimed at predicting the postoperative exercise capacity using the perfusion scanning and those that did reported contradictory results. METHOD: We prospectively studied the preoperative spirometric, exercise tests and perfusion scans from in 49 consecutive patients who were admitted to Inha University Hospital with surgically resectable lung cancer from Jan. 1998 to Jun. 1999 29 patients who had any condition affecting the lung function and exercise capacity, or refused a surgical resection or a follow-up study were excluded. Spirometric and exercise tests were performed 6 months after operation in 20 patients. RESULTS: The predicted postoperative FEV1, FVC and TLC correlated well with the following corresponding postoperative values : γs and p value, 0.809 and 0.000 for the FEV1 ; 0.895 and 0.000 for the FVC ; 0.741 and 0.006 for the TLC, respectively. The measured postoperative exercise values were slightly higher than the postoperative exercise values predicted, VO(2max) and Wr(max), were as 112% of VO(2max) predicted and 119% of WR(max) predicted. The change in FEV1, FVC and TLC had a weak correlation with the change in VO(2max) and WR(max). CONCLUSION: The perfusion scan was a useful tool for predicting the postoperative exercise capacity. However, they had a tendency to underestimate the exercise capacity, especially in the patients who had a pneumonectomy. A weak correlation between the change in lung function and exercise capacity was obseved.