Expression of Peroxiredoxin and Thioredoxin in Human Lung Cancer and Paired Normal Lung / 결핵및호흡기질환

BACKGROUND: Continuous growth stimulation by various factors, as well as chronic oxidative stress, may co-exist in many solid tumors, such as lung cancer. A new family of antioxidant proteins, the peroxiredoxins (Prxs), have been implicated in the regulation of many cellular processes, including cell proliferation, differentiation and apoptosis. However, a real pathophysiological significance of Prx proteins, especially in lung disease, has not been sufficiently defined. Therefore, this study was conducted to investigate the distribution and expression of various Prx isoforms in lung cancer and other pulmonary conditions. METHOD: Patients diagnosed with lung cancer, and who underwent surgery at the Ajou Medical Center, were enrolled. The expressions of Prxs, Thioredoxin (Trx) and Thioredoxin reductase (TR) were analyzed using proteomic techniques and the subcellular localization of Prx proteins was studied using immunohistochemistry on normal mouse lung tissue. RESULT: Immunohistochemical staining has shown the isoforms of Prx I, II, III and V are predominantly expressed in bronchial and alveolar lining epithelia, as well as in the alveolar macrophages of the normal mouse lung. The isoforms of Prx I and III, and thioredoxin were also found to be over-expressed in the lung cancer tissues compared to their paired normal lung controls. There was also an increased amount of the oxidized form of Prx I, as well as a putative truncated form of Prx III, in the lung cancer samples when analyzed using 2-dimensional electrophoresis. In addition, a 43 kDa intermediate molecular weight protein band, and other high molecular weight bands of over 20 kDa, recognized by the anti-Prx I antibody, were present in the tissue extracts of lung cancer patients on 1-Dimensional electrophoresis, which require further investigation. CONCLUSION: The over-expressions of Prx I and III, and Trx in human lung cancer tissue, as well as their possible chaperoning function, may represent an attempt by tumor cells to adjust to their microenvironment in a manner advantageous to their survival and proliferation, while maintaining their malignant potential.

A Case of RUL Bronchopleural Fistula Occluded by Flexible Bronchoscope with Endobronchial Watanabe Spigot (EWS) / 결핵및호흡기질환

An 86 year old woman was admitted complaining of dyspnea and right pleuritic pain with a 5 week durations. A physical examination, chest X-ray, and diagnostic thoracentesis upon admission revealed findings consistent with severe pneumonia and empyema on the right lung. Despite the insertion of a chest tube and negative suction via Emersion pump, the continuous air leakage was sustained, and a bronchopleural fistula (BPF) was found on the chest-CT. A flexible bronchoscopic occlusion with an Endobronchial Watanabe Spigot (EWS) was performed after 56 days of admission. An 5 mm diameter EWS was successfully inserted into the anterior segmental bronchus of the right upper lobe by flexible bronchoscope. There was no aAir leakage detected after this procedure. The patient was discharged 30 days after the EWS occlusion.

A Case of Myxedema Coma with Severe Hypoventilation / 대한내분비학회지

A myxedema coma, representing the extreme feature of hypothyroidism is rare. Despite early vigorous treatment, a myxedema coma is associated with a mortality rate as high as 60%. Herein, a case of a myxedema coma, with severe hypoventilation, is described. When the patient arrived at the emergency room, she complained of dyspnea and general weakness, and was of a drowsy mental status. 7 days after admission, she was more confused and disoriented, and respiratory insufficiency had developed. Although levothyroxine was continued and her respiration improved, she still had a confused mentality and seizure developed. Despite medication her consciousness did not improve, so was discharged in despair by her family members. The respiratory abnormality with a myxedema coma is a depressed ventilatory response to hypercapnea, resulting in a decrease in alveolar ventilation, with progressive CO2 retention. An upper airway obstruction, especially during sleep, and neuromuscular dysfunction in breathing may be shown in hypothyroidism. Therefore, a myxedema coma, accompanied by severe hypoventilation, should be intensively treated with thyroid hormone replacement therapy and mechanical ventilatory support

A Case of Langerhans Cell Histiocytosis with Sclerosing Cholangitis / 대한소화기내시경학회지

Langerhans cell histiocytosis is a rare disorder with abnormal proliferation of histiocytes. Besides the infiltration of a variety of organs, patients with Langerhans cell histiocytosis can develop sclerosing cholangitis, with bile duct involvement, progressive fibrosis, and cirrhosis. We report a case of Langerhans cell histiocytosis with sclerosing cholangitis. Endoscopic retrograde cholangiopancreatography revealed multiple strictures and dilatations of left intrahepatic and extrahepatic bile duct. Endoscopic biopsy of common bile duct showed diffuse infiltration of histiocytes and eosinophiles in lamina propria. Immunohistochemical stain showed positive reactions for S-100 and CD1a and a negative reaction for cytokeratin in infiltrating histiocytes.

Sutureless Small Incision ECCE with Phaco Prechopper

PURPOSE: The study was done to introduce the new small incision sutureless extracapsular cataract extraction (ECCE) surgical technique and its safety using phaco prechopper. METHODS: After 4.5 mm scleral frown incision from 2 mm surgical limbus, continuous curvilinear capsulorhexis and complete hydrodissection, nucleus was divided into 2 fragments with phaco prechopper which is special forceps for nuclear divider in the bag. One piece of lens was drawn into anterior chamber from capsular bag using Sinskey hook and removed it with Wilder lens loop (size:4 x15 mm) from anterior chamber. The other piece of lens was removed with the same method. To evaluate the safety of new method compared to phacoemulsification (P.E), analysis of the serial changes of the corneal endothelial cell density, hexagonal pattern and mean cell sizes before and 3months after the operation in 40eyes (ECCE group : 20eyes, P.E group : 20eyes) was made. RESULTS: There were no significant complications such as posterior capsular rupture, vitreous loss, capsulorhexis tear but transient corneal edema was found. The mean percentage of corneal endothelial cell loss was 9.05+/-6.5% in ECCE group and 9.80+/-6.7% in the P.E group. CONCLUSIONS: This new method is safe, easy and does not require expensive instrumentation. It can be of great help for the phaco beginners to practice capsulorhexis, hydrodissection and the use of phaco system. We think it is an alternative method for phacoemulsification in cataract surgery.

Cholesterol Crystals in Aqueous Humor of the Eye with Phacolytic Glaucoma

Iridescent cholesterol crystals in the anterior chamber are unusual finding. Although the clinical picture of phacolytic glaucoma is well recognized, the nature of the iridescent or hyperrefringent crystals is not well understood. A 70 years old womon presented with the acute onset of monocular pain and redness. The examination revealed a high intraocular pressure (42 mmHg), conjunctival hyperemia, and diffuse corneal edema. The heavy flare and pseudohypopyon were seen in the anterior chamber associated with iridescent or hyperrefringent particles. The anterior chamber aspirate obtained at operation was subsequently examined by wet field microscopy. Wet field microscopy showed that macrophages identified histologically in the aspirate corresponded to regular round cells about two to three times the size of an leukocyte. And, notched rectangular platelike crystals were typical morphologically of cholesterol, varied in size, and contacted each other. We found cholesterol crystals in aqueous humor of the eye with phacolytic glaucoma.