Prostaglandin E1 Inhibits CD64 (Fc gamma RI) Expression on Monocyte in Cultured Peripheral Blood Mononuclear Cells / 대한이식학회지

CD64 (Fc gamma RI) is the one of the three Fc gamma receptors on monocytes and represents a high affinity immunoglobin G receptor. CD64 is rapidly upregulated on monocyte in response to gamma interferone. X-linking of CD64 triggers an oxidative burst as well as antibody dependent cytotoxicity. In this experiments, peripheral blood mononuclear cells (PBMC) were separated and incubated with or without gamma interferone and PG E1. The samples were divided into four groups, the first was PBMC alone, the second was PBMC with gamma interferone 100 U/ml, the third was PBMC with gamma interferone 100 U/ml and Prostaglandin E1 1 micro M/L, and the fourth was PBMC with gamma interferone 100 U/ml and Prostaglandin E1 10 micro M /L. Flow cytometric measurements of CD64 on monocyte were performed at 0, 3, 6, and 9 hours after incubation and the mean fluorescence intensities (MFI) and the mean percentages of CD64(+) cell in monocytic gated area were obtained. After 6 hours of incubation, although there is no statistical significance, all gamma interferone added groups show the higher mean fluorescence intensity than PBMC alone group. Furthermore, at 6 and 9 hours of incubation, the mean percentages of CD64(+)cells between the PBMC with gamma interferone group and the PBMC with gamma interferone and PG E1 10 micro M/L group showed 74.83 +/- 9.72% vs. 34.07 +/-12.98%, 80.04 +/- 11.30% vs. 29.42 +/- 19.86% respectively, and there are statistical significances, p=0.05, p=0.05 respectively. It appears that PG E1 inhibits the expression of CD64 on monocyte.

Postrenal Transplantation Cyclosporine Associated Hemolytic Uremic Syndrome in End Stage Renal Failure Patient Caused by Systemic Lupus Erythematosus / 대한이식학회지

Although the outcome and the possibility of renal recurrence of disease in systemic lupus erythematosus is still a matter of controversy, kidney transplantation is generally regarded as a proper indication for the treatment of patients with end stage renal failure caused by systemic lupus erythematosus. Hemolytic uremic syndrome is characterized by the symptoms of sudden onset of hemolytic anemia, thrombocytopenia, and deteriorating renal function. Many patients with postrenal transplantation hemolytic uremic syndrome have lost their grafts because of no known established treatment modality. Although the substitution of cyclosporine to FK506 is reported as a successful strategy for the treatment of cyclosporine associated hemolytic uremic syndrome in many reported cases, we cannot find the constant reports because FK506 or even OKT3 is also known as the cause of postrenal transplantation hemolytic uremic syndrome. But cyclosporine associated hemolytic uremic syndrome can be treated by the proper choice of immunosuppressant and conservative treatment. In this report, a patient with end stage renal failure caused by systemic lupus erythematosus experienced cyclosporine associated postrenal transplantation hemolytic uremic syndrome. He has recovered from the symptoms by withdrawal of cyclosporine and reduced dose of FK506 and at the same time, conservative treatment. We report this case with literature review.

Changes of the Gastric Motility after Pylorus Preserving Pancreaticoduodenectomy

BACKGROUND: To evaluate delayed gastric emptying after a pylorus-preserving pancreaticoduodenectomy, we studied gastric motility in 11 normal volunteers and 11 patients who had undergone a pylorus-preserving pancreaticoduodenectomy. Additionally, the 24 hour esophageal Ph recordings were examined to evaluate gastroesophageal reflux after a pylorus-preserving pancreaticoduodenectomy. METHODS: Gastric motility was evaluated by using the gastric-emptying time and electrogastrograms. The gastric-emptying time was measured using a solid meal containing 99mTc-tin colloid. The half gastric-emptying time (GET1/2) was defined as the half time (T1/2) of the fall of gastric isotopic activity from the peak. Electrogastrogram (EGG) signals were detected from the surface electrodes on the skin overlying the gastric antrum. The 24-hour esophageal Ph was monitored by using a nasoesophageal probe placed in the distal esophagus 5 cm above the lower esophageal sphincter. RESULTS: In our study, the normal volunteers showed a 99+/-35 minute half gastric-emptying time. The patients were divided into two groups by a time of 2 months after the operation, early and late postoperative groups. Delayed gastric emptying after a pylorus-preserving pancreaticoduodenectomy in the early postoperative period (272+/-176 minutes) was normalized in the late period (106+/-37 minutes), p=0.020. Abnormal early EGG patterns also normalized in the late postoperative period. There was no significant difference of total Ph<4-time % between patients in the early (0.1+/-0.1%) and the late postoperative periods (0.4+/-0.4%), p=0.064. CONCLUSIONS: It is supposed that anatomical and functional preservation of the stomach and the proximal part of the duodenum after a pylorus-preserving pancreaticoduodenectomy enabled gastric motor activity to be normal in the late postoperative period.

Comparison of Polypropylene Mesh and Expanded Polytetrafluoroethylene Patch for Repair of Abdominal Wall Defects in Rat

BACKGROUND: Large abdominal wall defect resulting from trauma, invasive infection, tumor resection, or other causes continue to be major problems for patients and surgeons. The lack of sufficient tissue may require the insertion of prosthetic materials. This study compares the results of PPM mesh and e-PTFE patch for repairs of abdominal wall defects. METHODS: The anterior abdominal walls of Sprague-Dawley rats, including fascia, muscle, and peritoneum were removed. The defects were repaired with a PPM mesh or an e-PTFE patch. Animals were killed at 1, 2, 6, and 12 weeks after the operation, and the implant were excised along their margins and evaluated for gross and microscopic differences. RESULTS: Histological examination showed that PPM was progressively infiltrated by whorled disorganized collagen fiber, which became densely adherent to the mesh. In contrast, the e-PTFE was infiltrated by fine fibrils of collagen, which progressively penetrated the interstices of the material, binding it firmly to the tissue. One of the most serious complications associated with fascial closure with PPM was the development of visceral adhesions. CONCLUSIONS: e-PTFE patch material has a lower foreign body reaction, a lower infectability, and a lower rate of adhesion formation than PPM mesh.

Toxicity of Bile Acids on Colon Cancer Cell Lines / 대한암학회지

PURPOSE: Cytotoxicity of the bile acids on colon cancer cell lines was studied to know which bile acid was most cytotoxic to colonic mucosal epithelium. We performed agarose gel electrophoresis whether this toxicity was caused by detergent effect of the bile acids or by apoptotic pathway. MATERIALS AND METHODS: HT29, LoVo, SW620 colon cancer cell lines were exposed to lithocholate, cholate, deoxycholate and chenodeoxycholate with 50, 100, 150, 200, 250, 300 pM as final concentration in DMEM culture media for short time (for 2 hours) and for long time (for 5 days). Agarose gel electrophoresis was performed on each colon cancer cell lines (HT29, LoVo, SW620, SW480) after 1, 2, 3, 4, 5 days exposure to deoxycholate with 150 pM concentration to detect intemucleosomal fragmentation. RESULTS: There was no toxicity after short time exposure in all bile acids concentration and in all colon cancer cell lines. Of the bile acids, deoxycholate was most toxic for all colon cancer cell lines. And DNA fragmentation was noticed after 2 days exposure with deoxycholate. Only LoVo cell line showed apoptotic DNA pattern after 4 days of exposure with deoxycholate. CONCLUSION: Bile acids (especially deoxycholate) are suggested to be possible agents to cause apoptosis in colonic mucosal epithelium.

The Occlusions of both Femoral Artery Bifucations by Myxomas: A case report

We describe a patient with an unusual cause of the occlusions of both femoral arteries by myxomas. A 41-year-old man presented with sudden onset of both leg pain and paresthesia. His hematological and cardiological status was normal. Lower peripheral angiography was performed and demonstrated thrombotic occlusion, both common femoral artery and superficial femoral and proximal portion of deep femoral artery. He was successfully treated with surgical and forgaty catheter extraction. Histologic finding was myxoma probably from cardiac origin. Cardiac investigations to determine the source of the myxoma, including 2-D echocardiography and Transesophageal echocardiogram (TEE) of the heart, failed to demonstrate residual myxoma in heart. No residual tumor or potential source of the tumor was found. The cause of both leg pain was the occlusions of the both common femoral arteries by myxomas. An entire cardiac tumor might have embolized with no detectable residual tumor in the heart; alternatively a myxoma might have originated as a primary tumor in the femoral artery.

Differences in Serum CEA Level between Colon and Rectal Cancer

We investigated whether there is differences in serum level of carcinoembryonic antigen (CEA) between patients with colon and rectal cancer. Preoperative serum levels of CEA was determined in 65 patients with colon cancer and in 88 patients with rectal cancer. Cut-off value recommended by manufacturers is 5 ng/ml for CEA. At the recommended cut-off levels for CEA, overall sensitivity of CEA was 43.1 percent for colon and 42.0 percent for rectal cancer. In colon cancer CEA was elevated in 38.4, 46.2, 60 percent of patients with Dukes Stages B, C, and D, respectively. In rectal cancer CEA was elevated in 12.5, 31.6, 44.8, 84.6 percent of patients with Dukes Stages A, B, C, and D, respectively. In Stages B, and C, sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. In Stages D, sensitivity of CEA was higher in rectal cancer than in colon cancer, but the difference was not significant. In overall stages sensitivity of CEA was higher in colon than in rectal cancer, but the difference was not significant. The difference was not significant either in overall or in different stages of colon and rectal cancer.

Expression of p53, bcl-2 Protein in Colorectal Cancer and Its Relationship to Pathologic Factor

PURPOSE: This study was undertaken to evaluate the correlation between p53, bcl-2 expression and pathologic factors stage, anatomic location, histologic grade, gross pattern, lymph node metastasis of the colorectal cancer. METHODS: Analysis were made on archival pathology tissue of 56 patients with colorectal cancer. The oncoproteins were localized using commerically available monoclonal antibodies : DO-7 for, p53 and clone 124 for bcl-2. RESULTS: P53 protein was detected in 53 out of 56(94.6%) adenocarcinomas of the colorectal cancer and the most frequently expressed patterns of immunoreactivity of p53 were strong in intensity in 40 cases(71.4%) and were diffuse in pattern in 39 cases(69.6%). Bcl-2 protein was detected in 34 out of 56(60.7%) adenocarcinomas of the colorectal cancer and the most frequently expressed patterns of immunoreactivity of bcl-2 were weak in intensity in 17 cases(30.3%) and were diffuse in pattern in 16 cases(28.6%). There was no correlation between p53, bcl-2 expression and Dukes' stage, anatomic location ,histologic grade, gross pattern of tumor, lymph node metastasis of the colorectal cancer. CONCLUSION: 53 mutation and bcl-2 expression are frequent event in human colorectal carcinoma as shown in this study, but p53 and bcl-2 protein expression is not significant independent predicator of aggressiveness and progression of colorectal cancers.

Small Flat Adenocarcinoma of the Colon Arising From Familial Adenomatous Polyposis Patient: Suggesting de novo Origin

Most adenocarcinomas of the colorectum arise in a visible benign precursor lesion, the adenoma, which is a monoclonal proliferation of dysplastic nonmalignant epithelial cells. Adenoma-adenocarcinoma sequence has been represented as the predominat pathogenetic pathway. But a small flat depressed colon cancer is characterized by non-polypoid growth pattem with no association of adenomatous tissues, which has tendency to early submucosal invasion and lymph node metastasis even in very small lesion (<10 mm). It supports de novo carcinogenesis of colorectal cancer, although most colorectal cancerarise in pre-existing adenoma. We report a case of small float colon adenocarcinoma arising in normal colonic epithelium rather than adenomatous polyp in familial adenomatous polyposis syndrome.

A Bacteriologic Investigation of the Acute Appendicitis

A study on the microbiology of appendiceal tissue or peritoneal fluid was carried out by the authors. A total of 40 specimens were examined, 21 of them(52.5%) were found to be positive, of which 13(61.9%) were polymicrobial and 8(38.1%) were monomicrobial. The most represented species were Escherichia coli (37.8%), Klebsiella (16.2%), Streptococcus (10.8%), and Bacteroides (8.1%). The most active drugs in vitro were found to be aminoglycosides (gentamycin, amikacin, tobramycin) and cefotaxime. The infectious complication developed in 6 patients and consisted of wound infection only. In view of relation of presence or absence of perforation of appendix with infectious complication, 4 of them arose from perforative appendicitis(36.4%) and 2 of them arose from nonperforative appendicitis(6.9%). On the other hand, in view of relation of presence or absence of organism cultured from appendiceal tissue or peritoneal fluid with infectious complication, all of them arose from positive cultures(28.6%) and none arose from negative cultures. The most represented bacterias from wound infection were Escherichia coli(40%) and Bacteroides(20%). Therefore, we suggest that an agent against anaerobes should be recommended when the appendix is perforative.