Differential Activation of Macrophages Based on Their Environment in Advanced Age / 전남의대학술지

The macrophage displays functional and phenotypic diversity, which appears, in no small part, to stem from the ability of macrophages to adapt functionally to changes in their tissue microenvironment. Here, we describe the differential activity of peritoneal macrophages with or without the presence of thioglycollate (TG), an inflammatory drug that encouraged the recruitment of macrophages, during aging. The peritoneal-resident macrophages dramatically reduced in phagocytosis and pro-inflammatory cytokines secretion with aging, whereas the functions of macrophages recruited by TG were not significantly changed with aging. These results suggest that macrophages may be changed by their environment in advanced age, and could provide possible explanations for the controversial results regarding differential changes in macrophages in other papers.

Versatile Functions of Caveolin-1 in Aging-related Diseases / 전남의대학술지

Caveolin-1 (Cav-1) is a trans-membrane protein that is a major component of the caveolae structure on the plasma membrane. Cav-1 is involved in the regulation of various cellular processes, including cell growth, differentiation, endocytosis, and in particular it has been implied in cellular senescence. Here we review current knowledge about Cav-1 in cellular signaling and discuss the role of Cav-1 in aging-related diseases.

Versatile Functions of Caveolin-1 in Aging-related Diseases / 전남의대학술지

Caveolin-1 (Cav-1) is a trans-membrane protein that is a major component of the caveolae structure on the plasma membrane. Cav-1 is involved in the regulation of various cellular processes, including cell growth, differentiation, endocytosis, and in particular it has been implied in cellular senescence. Here we review current knowledge about Cav-1 in cellular signaling and discuss the role of Cav-1 in aging-related diseases.

Expression of Caveolin-1 in Rat Urinary Bladder with Cyclophosphamide-Induced Cystitis / 대한배뇨장애요실금학회지

PURPOSE: The purposes of this study were to investigate the effect of cyclophosphamide (CYP)-induced inflammatory cystitis on caveolin 1 in rat urinary bladder and to determine the role of these molecules in the bladder dysfunction that occurs in inflammatory change in rat urinary bladder. METHODS: Female Sprague-Dawley rats were divided into control (n=30) and experimental (n=30) groups. Cystitis in experimental group was induced by intraperitoneal injection of CYP (200 mg/kg). The control group underwent an intraperitoneal saline injection. After 3 days, urodynamic studies were done to measure the contraction interval and contraction pressure. The expression and cellular localization of caveolin 1 were determined by Western blot and immunofluorescent study in rat urinary bladder. RESULTS: In cystometrograms, the contraction interval (minute) was significantly increased in the CYP-induced cystitis rats (15.8+/-1.5) than in the control group (6.3+/-0.5) (P<0.05). Conversely, the average contraction pressure (mmHg) was significantly higher in the CYP-induced cystitis rats (15.6+/-1.7) than in the control group (11.3+/-0.5) (P<0.05). Caveolin 1 was expressed in the capillaries, arteriols and venules. The protein expression of caveolin 1 was significantly decreased in the CYP-induced cystitis rats (P<0.05). CONCLUSIONS: Inflammatory change of urinary bladder maybe causes a significant change in the expression of caveolin 1. These findings suggest that caveolin 1 might have a functional role in the bladder dysfunction related with cystitis in rat urinary bladder.

Exercise type and muscle fiber specific induction of caveolin-1 expression for insulin sensitivity of skeletal muscle

It is well known that exercise can have beneficial effects on insulin resistance by activation of glucose transporter. Following up our previous report that caveolin-1 plays an important role in glucose uptake in L6 skeletal muscle cells, we examined whether exercise alters the expression of caveolin-1, and whether exercise-caused changes are muscle fiber and exercise type specific. Fifity week-old Sprague Dawley (SD) rats were trained to climb a ladder and treadmill for 8 weeks and their soleus muscles (SOL) and extensor digitorum longus muscles (EDL) were removed after the last bout of exercise and compared with those from non-exercised animals. We found that the expression of insulin related proteins and caveolins did not change in SOL muscles after exercise. However, in EDL muscles, the expression of insulin receptor beta (IRbeta) and glucose transporter-4 (GLUT-4) as well as phosphorylation of AKT and AMPK increased with resistance exercise but not with aerobic exercise. Also, caveolin-1 and caveolin-3 increased along with insulin related proteins only in EDL muscles by resistance exercise. These results suggest that upregulation of caveolin-1 in the skeletal muscle is fiber specific and exercise type specific, implicating the requirement of the specific mode of exercise to improve insulin sensitivity.

Clinical Aspects and Surgical Methods in Perianal Hidradenitis Suppurativa

PURPOSE: Hidradenitis suppurativa is a chronic suppurative and cicatricial inflammatory disease involving apocrine gland- bearing areas including the axilla, groin, and anogenital regions. Recurrence after surgery is not rare, and there is much debate about operative methods. This study analyzed the clinical characteristics and the relationship between different surgical methods and recurrences of perianal hidradenitis suppurativa. METHODS: A retrospective study of 20 patients with perianal hidradenitis suppurativa was done. The clinical characteristics were examined. The patients were divided into several groups (acute, chronic regional, chronic extensive) according to lesion status; then, different operative methods and recurrence rates were compared. RESULTS: All of the patients were male smokers. The mean age of onset was 28.4 years. The mean duration of disease was 10 years. The total number of operations, including incision and drainage, was 29 cases. Only 4 patients were overweight or obese. The most common symptom was pus discharge (52%). The recurrence rate after final surgery was 30.0%. After incision and drainage in the acute group, 7 of 8 cases (87.5%) recurred. In the chronic regional group, 5 of 9 cases (55.6%) experienced recurrence after excision and primary repair. After excision and healing by secondary intention, 1 of 7 cases (14.3%) had recurrence. In the case of one unroofing and marsupialization, there was no recurrence. In the chronic extensive group, 1 recurrence was noted in 4 unroofings and marsupializations. CONCLUSIONS: In the case of abscess, proper incision and drainage is needed, but further definitive surgery must be done. In the case of chronic disease, if the lesions are regional, excision and healing by secondary intention is more ideal for decreasing the recurrence rate. If the lesions are extensive, unroofing and marsupialization is recom-mended.

Rectal Carcinoid: Effectiveness of Endoscopic Resection

PURPOSE: Small-sized carcinoids, less than 1 cm, are easily detected using flexible sigmoidoscopy or total colonoscopy and can be treated by local excision. Recently, there has been many advances in the technique of endoscopic resection. The aim of this study was to determine the endoscopic findings of a rectal carcinoid and to evaluate the effectiveness of endoscopic resection. METHODS: We experienced 22 rectal carcinoids in 21 patients who were treated by endoscopic resection from June 1996 to February 1999. Nineteen cases were followed for an average of 21 months. Follow-up studies consisted of chest P-A, hepatic ultrasonography, and total colonoscopy. RESULTS: The male-to-female ratio was 1.6 to 1. The most common age group was the 4th decade. The tumor was located at the lower rectum in 10 patients, at the upper rectum in 10 patients, and at the rectosigmoid junction in 2 patients. The tumor sizes ranged from 3 to 12 mm in diameter and were smaller than 10 mm in 20 cases (90.1%). Endoscopic finding revealed that the tumors were covered by a normally appearing mucosa in 12 cases, were yellow-discolored polyps in 17 cases, and were sessile-type tumors in 19 cases. The method of treatment was an endoscopic mucosal resection (EMR, 14 cases) or a snare polypectomy (8 cases). Microscopically positive margins were noticed in four cases, two cases of EMR (2/14, 14%) and two cases of snare polypectomy (2/8, 25%). All the patients were alive and clinically free of disease; however, the duration of the follow-up is short. CONCLUSIONS: Endoscopic resection for rectal carcinoid tumors smaller than 1 cm in diameter is a safe, functional, time-saving, and effective treatment. If the tumor suggests a carcinoid, EMR is advised rather than a polypectomy even though the tumor is small. Microscopically positive margins are not absolute indications for further surgery in the treatment of carcinoids smaller than 1 cm in diameter. It is much more important for an endoscopist to be confident that the endoscopic resection is done completely. It is necessary to identify the factors influencing the malignancy potential and to have a longer follow-up.

Clinical and Physiologic Characteristics of Rectal Prolapse in Males

This study compares the sexual differences among rectal prolapse patients regarding the clinical and the physiologic characteristics with emphasis on males. METHODS: The clinical data, functional status and operative records of 43 patients, who had completed both clinical and functional evaluations were collected in a prospective database and were analyzed according to sex. The functional status of the patients was evaluated by Wexner's constipation score (0~30), Wexner's incontinence score (0~20), anorectal manometry, and pudendal nerve terminal motor latency (PNTML). RESULTS: The incidences of rectal prolapse in males (n=22) and in females (n=21) were similar. The age of onset for males was lower (mean standard deviation, 19.6 19.59 (50% in childhood) vs 52.0 20.75 years; p=0.001) and the duration of symptoms was longer (31.5+/-19.87 vs 12.5+/-14.31 years; p<0.001). Surgery in males was most commonly performed during the sexually active years (51.2+/-16.34 vs 64.5+/-13.19; p=0.006). The incidence of mucosal prolapse in males was higher (10/22 vs 4/17; p=0.065). The incidences and the severities of defecation difficulty in males and females were similar (n=12, mean Wexner score=8.4 vs n=12, mean Wexner score=9.9; p=NS) but, the incidences and the severities of fecal incontinence were lower in males (n=4, mean Wexner score=4.3 vs n=17, mean Wexner score= 14.2; p<0.001). The maximum resting pressure was higher in males (39.2+/-21.46 vs 26.3+/-19.98 mmHg; p=0.049), and the maximum squeezing pressure was better preserved (131.2+/-62.63 vs 67.5+/-37.99 mmHg; p<0.001). No significant difference existed in the PNTML. Female patients underwent abdominal resection rectopexy (n=6), perineal rectosigmoidectomy with lavatoroplasty (n=11), and Delorme's procedure (n=4), but all male patients preferred the perineal approach (rectosigmoidectomy with lavatoroplasty (n=8), Delorme's procedure (n=14)) for fear of sexual dysfunction after the abdominal approach. CONCLUSIONS: These findings suggest that the mechanism for developing rectal prolapse in male and female may be different and that surgical treatment should be tailored to the patient.

Clinical Application and Limit of Magnifying Colonoscopy / 대한소화기내시경학회지

BACKGROUND/AIMS: Magnifying colonoscopy was developed for detailed examination of the surface of colorectal neoplastic lesions. While magnifying colonoscopy is useful for differentiating neoplastic lesions from nonneoplastic ones, for evaluating early colorectal cancers, it still has limits in practice. This study was designed to clarify the usefulness and the limits of magnifying colonoscopy. METHODS: Three hundred and fifty-two lesions, which were observed using magnifying colonoscopy from July to August 1999 and whose histologies were proven, were analyzed according to their pit patterns. The pit patterns are I, normal round pits; II, large starry-shaped pits; IIIs, small round pits; IIIL, large round or rod-shaped pits; IV, branched or gyrus-like pits; and V, irregularly shaped or nonstructural pits. In cases where a pit pattern was hard to read, the pattern was classified as 'D'. RESULTS: The dominant pit pattern for protruded lesions was IIIL, accounting for 44.6%. In diminutive lesions (< or =5 mm), II and IIIL were equally common, 40% of the total for those lesions, respectively. In medium-sized lesions (from 6 to 10 mm), IIIL was the major pit pattern, 45.6% of the total for that type of lesion. In lesions larger than 10 mm, IIIL and IV were the most common pit patterns, each accounting for 26.7% of the total. The overall accuracy ratio of pit pattern diagnoses was 79.5%. The frequency of difficult pit patterns to read was 6.3%. Among them, 77.3% were due to difficulty in interpreting the pit patterns, and 22.7% were due to an inability to clarify the pit pattern because of poor staining. Ninety-one percent of the difficult cases to read involved diminutive lesions, and 86% of those difficult cases involved tubular adenomas. CONCLUSIONS: The 80% accuracy rate for pit pattern diagnosis suggests that magnifying colonoscopy is probably useful, but problems, such as poor staining due to mucus and difficulty with interpretation, still exist.

Delayed Bleeding in a Colonoscopic Polypectomy: An experience with 5,236 polypectomies

PURPOSE: Delayed hemorrhage rarely happens after a colonoscopic polypectomy, ranging from 0.2 to 1.8% in frequency. Although its occurrence is unpredictable and it may be serious in some cases, scanty data on its causes, characteristics, and effective management exist in Korea. This study was conducted to provide such data, especially data on the characteristics of delayed hemorrhage and its effective management. METHODS: From 1997 to 1999, one endoscopist at Song-Do Colorectal Hospital performed 5236 polypectomies on 2511 patients. Delayed hemorrhage occurred after 9 of those polypectomies, for a bleeding incidence rate of 0.17% (9/5236). The authors reviewed those 9 incidence of delayed hemorrhage, which involved 9 patients and 9 lesions, with emphasis on the characteristics of the bleeding and the treatment. RESULTS: The mean age of the 9 patients was 50 years, and the male-to-female ratio was 8: 1. The sigmoid colon was involved in 4 of those patients (44.4%), and the right-sided colon was involved in another 4 of those patients. Lesions smaller than 11 mm were either sessile or flat-elevated and accounted for 6 of the 9 lesions (66.7%). The remaning lesions, which were larger than 10 mm, were either pedunculated or semipedunculated. Three (3) of the 9 patients (33.3%) experienced bleeding on day 1, the most common bleeding day. Another 5 patients (55.6%) experienced bleeding during the next 4 days (days 2 to 5). The last patient experienced bleeding on day 9, the latest bleeding day. A snare polypectomy had been performed on 7 of the 9 patients (77.8%), and a hot biopsy had been performed on the other 2 (22.2%). All delayed bleeding was treated by using hemoclips; additional epinephrine injection was used in 55.6% of the cases and an additional detachable snare in 22.2%. Rebleeding was noticed the day following the initial treatment of bleeding in one case and was managed by using hemoclips. CONCLUSIONS: The first 5 days after a colonoscopic polypectomy are crucial, and caution is required during the next 5 days. Thorough knowledge about preventing and managing bleeding is essential.

Clinical Review of Melanosis Coli

PURPOSE: Melanosis coli, which is a relatively common disease encountered during colonoscopy, is a brownish or blackish pigmentation of the colon and is associated with the ingestion of anthraquinone compounds. Its histopathological pathogenesis is recognized as colonic epithelial apoptosis. This study was designed to identify the relation between melanosis coli and the colonic transit time, as well as the relation between melanosis coli and other clinical characteristics. METHODS: We reviewed the clinical records of 80 patients with melanosis coli who had been diagnosed by colonoscopy between Jan. 1997 and Sep. 1998. The colonic transit time was checked in 26 cases of patients with melanosis coli and in 28 cases of patients with constipation without melanosis coli by using the multiple marker bolus technique. RESULTS: 1) The frequency of melanosis coli in patients undergoing a total colonoscopy was 1.25% (80/6422). 2) The age distribution was 20 to 76 years old (mean: 49). The grade of melanosis coli seemed to be related with age. 3) The four causative agents related with melanosis coli were anthraquinone compounds (69.2%), tea (12.3%), herbs (12.3%) and health foods in that order. 4) The duration of medication was from 2 months to 20 years (mean: 48 months). The grade of melanosis coli seemed to be related with the duration of medication. 5) The colonic transit time was normal in 11 cases (42.3%) and delayed in 15 cases (57.5%) of melanosis coli and normal in 10 cases (35.7%) and delayed in 18 cases (64.3%) of patients with constipation without melanosicoli. 6) Colon polyps were detected in 12 cases (15%). However, no relation between the incidence of colon polyps and either the grade of melanosis coli or the duration of medication was noted. CONCLUSIONS: Melanosis coli is a marker of ingestion of some drugs, such as anthraquinone compounds, and/or some kinds of acidic polysaccharides. Melanosis coli is not an indicator of colonic motility disorder or a danger signal for colon polyps or cancer.

Endoscopic Characteristics and Management of

PURPOSE: A laterally spreading tumor (LST) has its own characteristic features and growth pattern. Information about LST is scanty in Korea, therefore this study was designed in order to contribute to the literature. METHODS: In this study, 43 patients with LSTs were included. The diagnoses were made by colonoscopy in all cases. Treatment options included endoscopic resection, transanal excision, and surgical resection. In reviewing and analyzing the cases, we made a special emphasis on size, classification, histology, and treatment. RESULTS: The most frequent location was the rectum, followed by the sigmoid colon and the ascending colon in that order. Lesions smaller than 20 mm accounted for 69.8%. Granular homogeneous LSTs, 41.9%. Lesions larger than 20 mm, except granular homogeneous LSTs, showed an abrupt increase in malignancy rate. Tubular adenomas accounted for 65.1%. The overall malignancy rate was 20.9%, and the submucosal cancer rate, 9.3%. There were no malignancies in the granular homogeneous LSTs. The malignancy rate for the mixed-nodule type lesions was 33.3% (4/12), and the nongranular LSTs, 38.5% (5/13). Polypectomy was done in 37.2% of the lesions, endoscopic mucosal resection (EMR) in 16.3%, and endoscopic piecemeal mucosal resection (EPMR) in 16.3%. The overall endoscopic resection rate was 83.7% (36/43). EMR was applicable to lesions smaller than 20 mm, and EPMR to those larger than 20 mm. Transanal resection was done in 2 cases with lesions. Five cases were resected surgically. Four of them were submucosal invasive lesions, and one, a mucosal lesion which was wide and had initially been thought to be a submucosal cancer. There were two recurrences during the average 15-month follow-up period. The follow-up rate was 81.4% (35/43). Of these 2 recurring cases, one patient was treated endoscopically and the other, transanally. CONCLUSIONS: LSTs show different behavior depending on the endoscopic classification. Granular homogeneous LSTs are seldom larger than 30 mm and are good candidates for endoscopic treatment. The mixed-nodule type and the nongranular type show a marked predisposition to malignancy when they are over 20 mm, and nongranular-type LSTs have a higher rate of submucosal invasive cancers. Thus, in the cases of the mixed-nodule and nongranular types, careful consideration should be given for deciding between endoscopic treatment and surgical resection. Complete resection should be assured to prevent recurrence, and follow-up surveillance is required in all lesions for more than 3 to 5 years.

Expression of Human Papillomavirus Type 16, Prototype and Natural Variant E7 Proteins using Baculovirus Expression System

Human papillomavirus (HPV) 16, E7 proteins derived from the prototype (Bac73) and natural variant (Bac101) E7 open reading frame were produced in Sf9 insect cells. The variant E7 gene occurred naturally by substitution mutation at the position of 88 nucleotide, resulting serine instead of asparagine. Using E7 specific monoclonal antibody (VD6), both E7 proteins were identified in recombinant baculovirus infected SF9 cells. Radiolabelling and immunoprecipitation analysis revealed that both E7 proteins were phosphoproteins. Immunostaining result showed that E7 proteins were mainly localized in the cytoplasm. Nuclear form of E7 proteins was also detected after a sequential fractionation procedure for removing chromatin structure. Considering that the VD6 recognition site in E7 protein is located within 10 amino acid at the N-terminus, this region appears to be blocked by the nuclear component. Western blot analysis revealed that nuclear form was more abundant than cytoplasmic E7 proteins. Time course immunostaining showed that the primary location of E7 protein was the nucleus and exported to the cytoplasm as proteins were accumulated. These events occurred similarly in both Bac73 and Bac101 infected Sf9 cells, suggesting that these two proteins may have similar biological functions.