The Bone Morphogenesis Protein-2 (BMP-2) is Associated with Progression to Metastatic Disease in Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Bone Morphogenetic Proteins (BMPs) are members of the TGF-beta superfamily and it has been demonstrated that BMPs enhance migration, invasion and metastasis. The purpose of this study was to identify the association between the serum BMP-2 level and the progression status of gastric cancer. MATERIALS AND METHODS: Fifty-five patients with metastatic gastric cancer (metastatic disease group), six patients with early gastric cancer without lymph node metastasis (the EGC group), and ten healthy control subjects were enrolled in this study. The serum BMP-2 level was quantified by use of a commercially available ELISA kit. In EGC group patients and patients with metastatic disease, whole blood was obtained before endoscopic mucosal resection and before the commencement of a scheduled cycle of systemic chemotherapy, respectively. RESULTS: No significant difference in the mean serum BMP-2 levels was observed between the control subjects and the EGC group patients (87.95 pg/ml for the control subjects and 84.50 pg/ml for the EGC group, p=1.0). However, the metastatic disease group patients had a significantly higher level of serum BMP (179.61 pg/ml) than the control subjects and EGC group patients (87.95 pg/ml for the control subjects and 84.50 pg/ml for the EGC group, p<0.0001). Moreover, the mean serum BMP-2 level from patients with a bone metastasis was significantly higher than the mean serum BMP-2 level from patients without a bone metastasis (204.73 pg/ml versus 173.33 pg/ml, p=0.021). CONCLUSIONS: BMP-2 seems to have a role in progression to metastatic disease in gastric cancer, especially in the late stage of tumorigenesis, including invasion and metastasis. BMP-2 may facilitate bone metastasis in gastric cancer. To confirm these findings, further studies are required with tissue specimens and the use of a cancer cell line.

The Effects of air-borne particulate matters on the Alveolar Macrophages for the iNOS Expression and Nitric Oxide with Nitrotyrosilated-proteins Formation / 결핵및호흡기질환

BACKGROUND: Particulate matters (PM) when inhaled is known to induce pulmonary diseases including asthma and chronic bronchitis when inhaled. Despite the epidemiological proofevidence, the pathogenesis of PM-related pulmonary diseases is unclearremain poorly understood. METHODS: Primary alveolar macrophages were harvested from the SPF and inflammatory rats by bronchioalveolar lavage (BAL). The cultured primary alveolar macrophages were treated with the medium only, PM only (5~40 microgram/cm2), LPS (5ng/ml) only, and PM with LPS for 24 and 48 hours. The level of secreted nitric oxide (NO) was assayed from the cultured medium by using the Griess reaction. The cultured cells were utilized for the western blotting against the inducible nitric oxide synthase (iNOS) proteins. Immunocyto- chemical staining against the iNOS and NT-proteins were performed in cells that cultured in the Lab-Tek(R) chamber slide after treatments. RESULTS: The PM that utilizein this experiments induced NO formation with iNOS expression in the cultured SPF and inflammatory rats alveolar macrophages, by itself. When the cells were co-treated with PM and LPS, there was a statistically significant synergistic effect on NO formation and iNOS expression over the LPS effect. The cells from the sham control showed minimal immunoreactivity for the NT-proteins. Significantly higher quantities of NT-proteins were detected in the PM and PM with LPS co-treated cells than from the sham control. CONCLUSION: Increased iNOS expression and NO formation with increased NT-proteins formation might be involved in the pathogenesis of PM-induced lung injury.

The Effects of Air-borne Particulate Matters on the Alveolar Macrophages for the TNF-alpha and IL-1beta Secretion / 결핵및호흡기질환

BACKGROUND: PM is known to induce various pulmonary diseases, including asthma, cancer, fibrosis and chronic bronchitis. Despite the epidemiological evidence the pathogenesis of PM-related pulmonary diseases is unclear. METHODS: This study examined the effects of PM exposure on the secretion of TNF-alpha and IL-1beta in the cultured alveolar macrophages. The cultured primary alveolar macrophages were treated with the medium, PM (5~20 microgram/cm2), LPS (5ng/ml), and PM with LPS for 24h and 48h respectively. ELISA was used to assay the secreted TNF-alpha and IL-beta in the culture medium. Western blotting was used to identify and determine the level of proteins isolated from the culture cells. The cells cultured in the Lab-Tek(R) chamber slides were stained with immunocytochemical stains. RESULTS: PM induced TNF-alpha and IL-1beta secretion in the culturing alveolar macrophages, collected from the SPF and inflammatory rats. However, the effects were only dose-dependent in the inflammatory macrophages. When the cells were co-treated with PM and LPS, there was a significant synergistic effect compared with the LPS in the both cell types. CONCLUSION: PM might be play an important role in the induction and/or potentiation of various lung diseases by oversecretion of TNF-alpha and IL-1beta.

A case of epiphrenic diverticulum with solitary mediastinal tumor / 대한내과학회지

Epiphrenic diverticulum(traction type) is such a rare disease. The case of this disease which is due to mediastinal tumor, not because of inflammatory adhesion or of motor disorder is especially hard to find. The patient was a 50-year-old male and admitted with the intermittent postprandial chest discomfort. The chest CT and esophagography showed epiphrenic diverticulum(traction type). The tumor was located at the left anterolateral of thoracic spine, adhered to the right wall of esophagus. We performed the diverticulectomy and extirpation of mediastinal tumor under left posterolateral thoracotomy. The tumor and the esophagus were well seperated without invasion to the esophagus. In the pathology of resected tissues, solitary neurofibroma was diagnosed. There was no complication or recurrence after surgical resection.

A Case of Sponataneous Regressing Retroperitoneal Fibrosis after Ureteral Stent Insertion / 대한신장학회잡지

A 76 year old man was admitted because of periumbilical aMominal pain and nausea for 20days before admission. Initial serum creatinine level was 6.1mg/dL. Radioisotope renography showed obstruc- tive uropathy in both ureters. Retrograde pyelography of the left kidney revealed about 1cm of filling defect on the level of L5. Percutaneous nephrostomography of the right kidney revealed ureteral stricture in the lower ureter. In order to preserve renal function, a double J stent was inserted into each ureter. Serum creatinine level decreased to 1.5mg/dL after the insertion of ureteral stents. 12 weeks later, both stents were removed. 3 months after removal of the ureteral stents, retroperitoneal fibrosis and hydronephrosis disappeared in follow up abdominal CT. Recent his serum creatinine has shown about 1.5mg/dL. The patient is under continuing observation with serum creatinine level and sonography for detection of recurrence. This is a rare case of retroperitoneal fibrosis which showed spontaneous regression after ureteral stent insertion for 12 weeks without ureterolysis or corticosteroid therapy. In this case, the ureteral stent played a important role in preserving renal function by relieving ureteral obstruction. But the key point was that in the early stage in the early stage of retroperitoneal fibrosis, it was thaught having reversible process. There are some reports that ureteral obstruction was relieved only by correction of fluid and electrolytes balance or ureter diversion such as percutaneous nephro-stomy. Corticosteroid therapy promotes this rever-sible change in early stage of this disease by immunosuppression and antiinflammatory reaction. But once fibrosis has established in late stage of retroperitoneal fibrosis, corticosteroid is not effective for reducing the fibrosis and ureteral obstruction. In that case, operation is the choice for preservation of renal function. We reported an idiopathic retroperitoneal fibrosis case which showed spontaneous regression after preserving renal function by double J stent insertion without ureterolysis or corticosteroid therapy. We thought that idiopathic retroperitoneal fibrosis is a reversible process in the early stage.

A Case of Bronchial Lipoma with Extrabronchial Growth causing Middle Lobe Syndrome and Pneumonia / 결핵

Benign pulmonary tumors are rare entities, and among them bronchial lipomas are the most uncommon. Up to date, about 80 cases have been reported in the English literature. But, the bronchial lipoma with extrabronchial growth causing middle lobe syndrome and pneumonia is extremely rare. Bronchial lipomas, mainly arising from normal fatty tissue of the proximal portion of the lobar or segmental bronchi, are histologically benign. But if diagnosis and treatments are delayed, they can produce extensive pulmonary parenchymal damage and irreversible brochiectasis distally. So whenever possible, the treatment of choice is resection by means of bronchoscopy via early diagnosis. But if endoscopic removal is not possible because the distal end of the tumor could not be visualized by fiberoptic bronchoscopy or if the nature of the tumor is unclear, surgery is necessary, with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma. We present a case of bronchial lipoma with extrabronchial growth, with a review of the literature and report of an unusual case.

A case of Fulminant Mycoplasma Pneumonia Complicated with ARDS and Hemolytic Anemia / 결핵

The frequency of fulminant peumonia due to Mycoplasma pneumoniae is relatively rare despite the high prevalence of Mycoplasma species infection in the general population We report a case of mycoplasma pneumonia complicated with severe ARDS, overt hemolytic anemia and hepatitis. He had high titers of antimycoplasma antibody and cold agglutinin. Despite erythromycin administration, the pneumonic infiltration on chest radiography was not resolved, and mechanical ventilation was needed for 16 days. During the therapeutic course, his hemoglobin decreased. After the administration of prednisolone, his hemoglobin increased and pneumonic infitration was totally resolved. He had a progressively favorable course and could be discharged in relatively good clinical condition.

A Study on the Serum Lipoperoxide Level in Normal Koreans

Serum lipoperoxide level was measured in 103 normal Koreas by TBA method. Concomitantly serum cholesterol, triglyceride, HDL-cholesterol and fasting blood sugar were measured for determinining correlationship to serum lipoperoxide. The mean value of serum lipoperoxide level in normal Koreans was 2.41+/-0.45 nmoles MDA/ml. Age and serum triglyceride level were significantly correlated with serum lipoperoxide level (r=0.51, 0.25, p<0.001, p<0.02), whereas serum cholesterol, HDL-cholesterol and fasting blood sugar were not.