A Phage Display-Identified Peptide Selectively Binds to Kidney Injury Molecule-1 (KIM-1) and Detects KIM-1–Overexpressing Tumors In Vivo / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study was carried out to identify a peptide that selectively binds to kidney injury molecule-1 (KIM-1) by screening a phage-displayed peptide library and to use the peptide for the detection of KIM-1overexpressing tumors in vivo. MATERIALS AND METHODS: Biopanning of a phage-displayed peptide library was performed on KIM-1–coated plates. The binding of phage clones, peptides, and a peptide multimer to the KIM-1 protein and KIM-1–overexpressing and KIM-1–low expressing cells was examined by enzyme-linked immunosorbent assay, fluorometry, and flow cytometry. A biotin-peptide multimer was generated using NeutrAvidin. In vivo homing of the peptide to KIM-1–overexpressing and KIM1–low expressing tumors in mice was examined by whole-body fluorescence imaging. RESULTS: A phage clone displaying the CNWMINKEC peptide showed higher binding affinity to KIM-1 and KIM-1–overexpressing 769-P renal tumor cells compared to other phage clones selected after biopanning. The CNWMINKEC peptide and a NeutrAvidin/biotin-CNWMINKEC multimer selectively bound to KIM-1 over albumin and to KIM-1–overexpressing 769-P cells and A549 lung tumor cells compared to KIM-1–low expressing HEK293 normal cells. Co-localization and competition assays using an anti–KIM-1 antibody demonstrated that the binding of the CNWMINKEC peptide to 769-P cells was specifically mediated by KIM-1. The CNWMINKEC peptide was not cytotoxic to cells and was stable for up to 24 hours in the presence of serum. Whole-body fluorescence imaging demonstrated selective homing of the CNWM-INKEC peptide to KIM-1–overexpressing A498 renal tumor compared to KIM1–low expressing HepG2 liver tumor in mice. CONCLUSION: The CNWMINKEC peptide is a promising probe for in vivo imaging and detection of KIM-1‒overexpressing tumors.

Effects of Eye Registration on the Astigmatism Correction in the Surface Laser Ablation

PURPOSE: To compare the effect of astigmatism correction upon Mel 80 excimer laser surgery with or without an eye registration system. METHODS: This retrospective analysis investigates a group (eye registration group) of surface laser ablation surgeries for myopic astigmatism correction, with operation on 27 eyes from 15 patients with guidance of the eye registration system and 40 eyes from 29 patients without guidance from the eye registration system. The evaluation of astigmatism correction was performed by the Alpins method, measuring the amount and axis of astigmatism before and after the operations. RESULTS: The average of the correction index (the ratio of the surgically induced amount of astigmatism correction to the intended amount of astigmatism correction) for the eye registration group was calculated to be 0.94+/-0.30 and, for non-eye registration group, was 0.92+/-0.41, showing no statistical significant difference between the two groups (p=0.762). However, the comparison of the index of success (the ratio of the difference vector to the intended amount of astigmatism correction) favorably demonstrated the effectiveness of eye registration (0.23+/-0.34 for eye registration group, 0.47+/-0.54 for non-eye registration group, p=0.03). The absolute angle of error (AE), a measure of difference in angle between the ablated axis of astigmatism correction and the desired axis of astigmatism correction, was lower on average for the eye registration group than for the non-eye registration group (3.52+/-7.69 to 12.5+/-20.69 degrees, p=0.015). CONCLUSIONS: Eye registration-guided surface laser ablation is suggested to be beneficial for the reduction of errors in astigmatism correction.

The Long-Term Effect of Part-Time Occlusion Therapy According to Compliance in Recurrent Intermittent Exotropia

PURPOSE: To evaluate the reoperation rate and the change of exo-angle according to compliance level of part time occlusion therapy in recurrent intermittent exotropia. METHODS: This retrospective study included 52 patients of recurrent intermittent exotropia who followed up more than 5 years after their first operation. They were ordered part time occlusion therapy for recurrent exotropia. The patients were divided into 4 groups according to the level of compliance of part time occlusion therapy ('excellent', 'good', 'fair', 'poor'). We evaluated the reoperation rate in 5 years after the first operation and the change of exo-angle from the early recurrent time according to compliance levels. RESULTS: The reoperation rate within 5 years after the first operation of 'excellent' and 'good' compliance groups was lower than that of 'fair' and 'poor' groups (33.3, 26.3, 73.7 and 45.5% respectively) and the degree of exo-angle progression from the early recurrent time of the 'excellent' and 'good' compliance groups was less than that of 'fair' and 'poor' compliance groups, both results of which were statistically significant (p=0.02, 0.03). CONCLUSIONS: Part time occlusion therapy in recurrent intermittent exotropia has good long-term effects of decreasingreoperation rates in patients with a high level of compliance.

The Clinicopathologic Characteristics of Patients with Gastric Carcinoid Tumor

PURPOSE: We wanted to analyze the clinicopathologic characteristics of patients with gastric carcinoid tumor, which is a rare gastric tumor (less than 2% of all gastric tumors). MATERIALS AND METHODS: We reviewed all the carcinoid patients who were treated from 1996 to 2006. The clinicopathologic characteristics, the treatment modalities and the survival rates were retrospectively analysed. RESULTS: There were 8 type I patients and 10 type III patients, but there were no type II patients. The mean age of onset for type I was 47.75 years and that for type III was 57.90 years. More type III patients were female, but the gender ratio of type I patients was equal at a ratio of 1:1. There were 4 cases of solitary tumor, which were all T1 except for one case, and there was neither distant metastasis nor lymph node involvement for the type T1 cases. In the 13 patients who had no metastasis, 5 underwent endoscopic mucosal resection and 8 underwent surgery, and their combined 5 year survival rate was 92.3%. For the 5 cases who had metastastses, their mean survival was 22 months and especially, 3 of them underwent palliative surgery and their median survival were 24 months (95%, +/-6.52). CONCLUSION: Higher incidence of type III gastric carcinoid tumor and less multiplicity in type I gastric tumor were identified in our study compared with previous reports. For the type III cases, there were some noteable differences compared with the Western country's survival rate for the patients who underwent palliative surgery, so physicians must pay close attention to the definite clinicopathologic characteristics of gastric carcinoid patients.

Postoperative Pain and Epithelial Wound Healing in Epi-LASIK With and Without an Epithelial Sheet Preservation

PURPOSE: To investigate the influence of preservation of an epithelial sheet in Epi-LASIK on postoperative pain and epithelial wound healing time. METHODS: This prospective study included 34 eyes of 17 patients with myopia who received Epi-LASIK. An epithelial flap was created using the epikeratome (Centurion SES, Norwood Abbey EyeCare, Australia). After the stroma was ablated using the MEL 80 (Carl Zeiss Meditec. Germany) excimer laser, the epithelial sheet was replaced on the stromal bed in one randomly selected eye of each patient, and removed in the contralateral eye. The pain scores at postoperative day 0, 1, 2, 5 and the numbers of days for the complete epithelial wound healing were compared between the sheet-preserved and the sheet-removed eyes. At 1 month postoperative, uncorrected visual acuity (UCVA), refractive error and corneal haze were also compared. RESULTS: Pain scores on the day of operation were lower in sheet-preserved group and statistically significant (p=0.01). On postoperative day 1, 2, and 5, pain scores did not reach statistical significance (p=0.24, 0.08, 0.56, respectively). The mean epithelial healing time was 4.88+/-0.93 days for the flap-preserved eyes and 4.29+/-0.77 days for the flap-removed eyes, which showed statistical significance (p=0.01). No significant difference was noted between the 2 groups for mean UCVA, corneal haze and refractive error at 1 month postoperative. CONCLUSIONS: A preserved epithelial sheet reduced early postoperative pain but did not accelerate epithelial wound-healing rate.

A case of postprandial hypotension presenting with postprandial dizziness / 대한내과학회지

Postprandial hypotension is an important minor clinical problem. It is a common disorder that causes unexplained dizziness, falls, lightheadedness, syncope, angina pectoris, and even transient ischemic attacks of the brain. It is often defined as a decrease in systolic blood pressure by more than 20 mmHg within 2 hours after a meal. The mechanism of postprandial hypotension is splanchnic blood pooling via the loading of glucose in the intestine and decompensation of the autonomic nervous system. The best tool for detecting a fall in systolic blood pressure is 24-hour ambulatory blood pressure monitoring. Acarbose, an alpha-glucosidase inhibitor, is very useful for preventing postprandial hypotension. We experienced a case of postprandial hypotension that presented with postprandial dizziness. The patient was treated successfully with acarbose before each meal.

Ocular Findings in Cri Du Chat Syndrome: A Case Report

PURPOSE: To report the ophthalmologic examination of an infant who has cri du chat syndome with exotropia and facial abnormalities. CASE SUMMARY: A 7 - month - old infant was confirmed as having cri du chat syndrome by a chromosomal study. He showed mild developmental retardation and eyeball deviation. This male infant underwent ophthalmic evaluations, including an extraocular examination, measurement of deviation, ocular movement test, interepicanthal distance, and fundus examination. As a result, facial abnormalities were found, including telecanthus and epicanthal folds. The infant had intermittent exotropia of 40 prism diopters according to the Hirschberg test and optic atrophy according to the fundus examination. CONCLUSIONS: Cri du chat syndrome manifests with many different ocular symptoms, including hypertelorism, telecanthus, epicanthal folds, and exotropia.

A Case of Double Primary Cancer that Occurred Continuously at the Esophagogastric Junction / 대한소화기내시경학회지

The occurrence of multiple primary cancers associated with the esophagus and stomach is a well known phenomenon. However, the majority of those lesions are located apart each other. Finding of esophageal cancer and gastric cancer occurring simultaneously at the esophagogastric junction is extremely rare. In this case, the endoscopic findings showed that the cancer of the gastric cardia had invaded to the lower esophagus, but after the operation, the pathology report show the synchronous occurrence of esophageal squamous cell carcinoma and gastric adenocarcinoma. Therefore, we report here on a rare case of double primary cancer, and this double primary cancer occurred at the esophagogastric junction of a 67 year-old woman.

A Case of Esophageal Anisakiasis Presenting as Chest Pain Mimicking Angina / 대한소화기내시경학회지

Chest pain of a non-cardiac origin is frequently seen in medical practice. This kind of chest pain is often difficult to differentiate from chest pain of a cardiac origin. Esophageal anisakis is a rare finding, but it can cause chest pain. We report here on a patient who had a history of acute myocardial infarction and who also had one stent inserted in his left anterior descending coronary artery two month previously. The patient presented with substernal chest pain that mimicked anginal chest pain. Endoscopic examination revealed a whitish linear worm that had had invaded the esophagogastric junction, and we removed the worm with biopsy forceps. We report here on a patient with an esophageal anisakiasis as a rare cause of noncardiac chest pain that mimicked anginal chest pain.

Appendiceal Stump Bleeding That was Treated by Endoscopic Hemoclipping / 대한소화기내시경학회지

Appendiceal stump bleeding is a rare, but occasionally life-threatening complication. Significant lower gastrointestinal hemorrhage from an ulcerated appendiceal stump may occur after uncomplicated appendectomy. The common management includes ligation of the bleeding vessel or cecal resection by either emergency laparotomy or laparoscopy. Angiographic embolization of the bleeding vessel is an alternative therapeutic option. We report here on a case of gastrointestinal hemorrhage from an appendiceal stump, and this occurred six days after appendectomy. The bleeding was controlled endoscopically by placing hemoclips on the distinct vessel. The patient recovered thereafter without further intervention. Endoscopic hemoclipping is an effective and safe procedure, and it can replace emergency laparotomy, laparoscopy or angiographic embolization for treating appendiceal stump bleeding.

The Study on the Expression of Angiopoietin-1, Angiopoietin-2, and Tie2 in Mouse Kidney Maturation / 대한신장학회잡지

BACKGROUND: The Angiopoietin-1 (Ang1), Angiopoietin-2 (Ang2) and Tie2 have essential role in angiogenesis in development. Ang1 and Ang2 are ligands which binds to their receptor, Tie2. METHODS: Expression of these proteins was sought during mouse kidney maturation from embryonic day 16 (E16) to 28 days postnatal (P28). RESULTS: Using RNase protection assay and Western blot, these three molecules were expressed throughout the experimental period with peak levels at P28 (Ang1), P14 (Ang2) and P7 (Tie2). By immunohistochemical analysis, Ang1 protein was found to localize to condensing renal mesenchymal cells, and tubules. Ang2 proteins were detected in differentiating outer medullary tubules and the vasa recta bundle area. Tie2 protein was detected in a portion of glomerular tufts and cortical interstitium, and medulla including vessels in the vasa recta. CONCLUSIONS: These data suggest that Ang1, Ang2 and Tie2 proteins are expressed in renal development.

Apoptotic Effect of Radiocontrast Media on Human Umbilical Vein Endothelial Cells

The damage of vascular endothelial cells leads to the progression of vascular disease. Apoptotic damage of endothelial cells is an important mechanism in vascular disease. Recently, it has been reported that radiocontrast can induce vascular endothelial cell injury. The present study used terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) and FACScan analysis to examine whether radiocontrast agenst, such as iopromide, sodium-meglumine-ioxithalamate or gadopentetate dimeglumine, induce apoptotic injury in human umbilical vein endothelial cells. In the study, iopromide, sodium-meglumine-ioxithalamate and gadopentetate dimeglumine brought about human umbilical vein endothelial cell death in phase-contrast microscopic findings. According to TUNEL and FACScan analysis, iopromide and sodium-meglumine- ioxithalamate induced apoptosis in vascular endothelial cells in a dose-dependent. The apoptotic effect of sodium-meglumine-ioxithalamate was shown to be greater than that of iopromide. Gadopentetate dimeglumine also induced apoptosis in human umbilical vein endothelial cells as observed by TUNEL and FACScan analysis. These results suggest that iopromide, which is a non-ionic radiocontrast agent, proved to be less apoptotic than sodium-meglumine-ioxithalamate. Gadopentetate dimeglumine, which is used MRI, has an apoptotic effect in vascular endothelial cells. Thus, apoptosis of endothelial cells by radiocontrast agents might induce deleterious effects on vascular endothelial integrity.

A case of fabry's disease with chronic renal failure effectively managed with CAPD / 대한신장학회잡지

No abstract available.