Proliferation of Mouse Prostate Cancer Cells Inflamed by Trichomonas vaginalis

Our objective was to investigate whether inflammatory microenvironment induced by Trichomonas vaginalis infection can stimulate proliferation of prostate cancer (PCa) cells in vitro and in vivo mouse experiments. The production of CXCL1 and CCL2 increased when cells of the mouse PCa cells (TRAMP-C2 cell line) were infected with live T. vaginalis. T. vaginalis-conditioned medium (TCM) prepared from co-culture of PCa cells and T. vaginalis increased PCa cells migration, proliferation and invasion. The cytokine receptors (CXCR2, CCR2, gp130) were expressed higher on the PCa cells treated with TCM. Pretreatment of PCa cells with antibodies to these cytokine receptors significantly reduced the proliferation, mobility and invasiveness of PCa cells, indicating that TCM has its effect through cytokine-cytokine receptor signaling. In C57BL/6 mice, the prostates injected with T. vaginalis mixed PCa cells were larger than those injected with PCa cells alone after 4 weeks. Expression of epithelial-mesenchymal transition markers and cyclin D1 in the prostate tissue injected with T. vaginalis mixed PCa cells increased than those of PCa cells alone. Collectively, it was suggested that inflammatory reactions by T. vaginalis-stimulated PCa cells increase the proliferation and invasion of PCa cells through cytokine-cytokine receptor signaling pathways.

Involvement of Macrophages in Proliferation of Prostate Cancer Cells Infected with Trichomonas vaginalis

Macrophages play a key role in chronic inflammation, and are the most abundant immune cells in the tumor microenvironment. We investigated whether an interaction between inflamed prostate cancer cells stimulated with Trichomonas vaginalis and macrophages stimulates the proliferation of the cancer cells. Conditioned medium was prepared from T. vaginalis-infected (TCM) and uninfected (CM) mouse prostate cancer (PCa) cell line (TRAMP-C2 cells). Thereafter conditioned medium was prepared from macrophages (J774A.1 cell line) after incubation with CM (MCM) or TCM (MTCM). When TRAMP-C2 cells were stimulated with T. vaginalis, protein and mRNA levels of CXCL1 and CCL2 increased, and migration of macrophages toward TCM was more extensive than towards CM. Macrophages stimulated with TCM produced higher levels of CCL2, IL-6, TNF-α, their mRNAs than macrophages stimulated with CM. MTCM stimulated the proliferation and invasiveness of TRAMP-C2 cells as well as the expression of cytokine receptors (CCR2, GP130, CXCR2). Importantly, blocking of each cytokine receptors with anti-cytokine receptor antibody significantly reduced the proliferation and invasiveness of TRAMP-C2 cells. We conclude that inflammatory mediators released by TRAMP-C2 cells in response to infection by T. vaginalis stimulate the migration and activation of macrophages and the activated macrophages stimulate the proliferation and invasiveness of the TRAMP-C2 cells via cytokine-cytokine receptor binding. Our results therefore suggested that macrophages contribute to the exacerbation of PCa due to inflammation of prostate cancer cells reacted with T. vaginalis.

Comparison of Two PCR Assays for Trichomonas vaginalis

PCR is known to be the most sensitive method for diagnosing Trichomonas vaginalis infections. This study aimed to compare the sensitivity of a PCR assay for trichomoniasis (HY-PCR) developed in Hanyang University with the use of a Seeplex Ace Detection Kit®, using urine collected from four Korean men with prostatic disease. Overall, HY-PCR was more sensitive than the Seeplex Kit. The use of Chelex 100 is recommended for DNA isolation in order to increase the sensitivity of the PCR test.

Posterior Glenoid Lesions on Magnetic Resonance Imaging in Adolescent Baseball Players / 대한스포츠의학회지

The purpose of this study is to evaluate the characteristics of posterior glenoid lesion (PGL) on magnetic resonance imaging (MRI) in adolescent baseball players. Seventy-two adolescent baseball players (mean age, 15.1 years) who underwent MRI scan for dominant shoulder pain were enrolled and the location and morphologic features of PGLs were assessed on MRI. All players were divided into three groups based on the physeal status of proximal humerus: group I, open; group II, partial closure; and group III, complete closure. Of the 72 players, posterior glenoid rim rounding (69%) and periosteal thickening (88%) were the main PGL on axial imaging. Osteochondritis dissecans (OCD) of glenoid (10%), Bennett lesion (6%), and posterior labral tear (21%) were also identified. On oblique sagittal imaging, bony PGL including OCD involves mid-portion of posterior glenoid consistent with the level of the infraspinatus muscle, but Bennett lesion was located relatively lower than PGL. Posterior glenoid rim rounding was more prevalent in younger players (group I, 86%; group II, 78%; group III, 43%; p=0.015), and posterior labral tears were in older players (group I, 0%; group II, 19%; group III, 38%, p=0.027). Factors related with prevalence of posterior glenoid rim rounding were increased body mass index (p=0.016), pitchers (p=0.024), and players with posterior shoulder tightness (p=0.023), but career length was not statistically significant (p=0.089). Decreasing the rate of posterior glenoid rim rounding with skeletal growth implies that it may be recovered through the remodeling process, and labral tears are increasing internal impingement lesion after physeal closure.

Interaction between Trichomonas vaginalis and the Prostate Epithelium

Most men infected with Trichomonas vaginalis are asymptomatic and can remain undiagnosed and untreated. This has been hypothesized to result in chronic persistent prostatic infection. Adhesion of the protozoan organisms to mucosal cells is considered a first and prerequisite step for T. vaginalis infection. Adhesion of T. vaginalis to prostate epithelial cells has not yet been observed; however, there are several reports about inflammation of prostate epithelial cells induced by T. vaginalis. The aim of this study was to investigate whether adhesion and cytotoxicity of T. vaginalis are involved in inflammation of prostate epithelial cells. When RWPE-1 cells were infected with T. vaginalis (1:0.4 or 1:4), adhesion of T. vaginalis continuously increased for 24 hr or 3 hr, respectively. The cytotoxicity of prostate epithelial cells infected with T. vaginalis (RWPE-1: T. vaginalis=1:0.4) increased at 9 hr; at an infection ratio of 1:4, cytotoxicity increased after 3 hr. When the RWPE-1 to T. vaginalis ratio was 1:0.4 or 1:4, production of IL-1β, IL-6, CCL2, and CXCL8 also increased. Epithelial-mesenchymal transition (EMT) was verified by measuring decreased E-cadherin and increased vimentin expression at 24 hr and 48 hr. Taken together, the results indicate that T. vaginalis adhered to prostate epithelial cells, causing cytotoxicity, pro-inflammatory cytokine production, and EMT. Our findings suggest for the first time that T. vaginalis may induce inflammation via adhesion to normal prostate epithelial cells.

Inflammatory Responses in a Benign Prostatic Hyperplasia Epithelial Cell Line (BPH-1) Infected with Trichomonas vaginalis

Trichomonas vaginalis causes the most prevalent sexually transmitted infection worldwide. Trichomonads have been detected in prostatic tissues from prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. Chronic prostatic inflammation is known as a risk factor for prostate enlargement, benign prostatic hyperplasia symptoms, and acute urinary retention. Our aim was to investigate whether T. vaginalis could induce inflammatory responses in cells of a benign prostatic hyperplasia epithelial cell line (BPH-1). When BPH-1 cells were infected with T. vaginalis, the protein and mRNA of inflammatory cytokines, such as CXCL8, CCL2, IL-1β, and IL-6, were increased. The activities of TLR4, ROS, MAPK, JAK2/STAT3, and NF-κB were also increased, whereas inhibitors of ROS, MAPK, PI3K, NF-κB, and anti-TLR4 antibody decreased the production of the 4 cytokines although the extent of inhibition differed. However, a JAK2 inhibitor inhibited only IL-6 production. Culture supernatants of the BPH-1 cells that had been incubated with live T. vaginalis (trichomonad-conditioned medium, TCM) contained the 4 cytokines and induced the migration of human monocytes (THP-1 cells) and mast cells (HMC-1 cells). TCM conditioned by BPH-1 cells pretreated with NF-κB inhibitor showed decreased levels of cytokines and induced less migration. Therefore, it is suggested that these cytokines are involved in migration of inflammatory cells. These results suggest that T. vaginalis infection of BPH patients may cause inflammation, which may induce lower urinary tract symptoms (LUTS).

Non-operative Treatment of Gastric Ulcer Perforation with Contrast Leakage in an Elderly Patient / 대한내과학회지

Peptic ulcer remains an important public health concern due to an aging society and the increasing use of non steroidal anti-inflammatory drugs (NSAIDs). Perforated peptic ulcer is a major life-threatening complication of peptic ulcer. While the preferred treatment is surgery, conservative treatment does not result in significantly different outcomes in young, hemodynamically stable patients. However, conservative treatment of perforated peptic ulcer is associated with high failure rates in elderly patients. We report a case of an 87-year-old patient with a perforated peptic ulcer with contrast agent leakage. The patient was treated conservatively without complications; the treatment included non per os (NPO), insertion of a Levin tube, intravenous antibiotics, and a proton pump inhibitor.

Metastatic Spermatic Cord Tumor From Colorectal Cancer

Metastatic tumors of the spermatic cord are extremely rare, and the prognosis for patients is typically poor. In the majority of cases, the primary tumor occurs in the gastrointestinal tract. We report a case of a 62-year-old man with a metastatic spermatic cord tumor. The patient complained of groin discomfort with a tender mass in the right inguinal area. An excisional biopsy was performed, and the pathologic finding was a metastatic mucinous adenocarcinoma. We performed a systemic evaluation including colonoscopy, abdominal computed tomography, and total-body positron emission tomography, and the primary tumor was confirmed to involve the total colon, including the cecum, sigmoid colon, and rectum. The pathologic finding for rectum revealed a mucinous adenocarcinoma compatible with a metastatic spermatic cord tumor.

A Case of Lead Migration Caused by Involuntary Movement in Implanted Spinal Cord Stimulation / 고신대학교의과대학학술지

Spinal cord stimulation (SCS) is a reliable clinical option for treatment of refractory chronic pain. It is known to be effective method for treating sympathetic pain, failed back surgery syndrome, and complex regional pain syndrome etc. The devices and implantation techniques for SCS are already highly developed and continuously improving, but there are some complications that can not be corrected easily. Lead migration is the most common complication after SCS. It can cause failure of SCS that can make discomfort to patients. Here we describe our experience of lead migration in implanted SCS which was inserted to a patient with complex regional pain syndrome patient.

Comparison of disinfective power according to application order of 70% isopropyl alcohol and 10% povidone-iodine / 대한마취과학회지

BACKGROUND: Many disinfectants have been used clinically in both single and combination applications, but there have been few studies on disinfective power according to sterilization sequence when using a combination of disinfectants. The purpose of this study was to evaluate the disinfective power of a combination of 70% isopropyl alcohol and 10% povidone-iodine (PVP-I) according to sterilization sequence. METHODS: Two hundred healthy volunteers were recruited. Subjects were disinfected with a combination of 70% isopropyl alcohol and 10% PVP-I on both forearms, in varying sequence. The AP group included disinfections on the left forearm with isopropyl alcohol first followed by 10% PVP-I, while the PA group included disinfections on the right forearm with same disinfectants in reverse order. Skin cultures were obtained using cotton swabs 3 min after application of each disinfectant, and then were inoculated on blood agar plates for bacterial culture. Cultures were incubated at 37degrees C under aerobic conditions for 48 hours. RESULTS: There was no significant difference in the number of positive cultures after the 1st disinfection (AP, 45; PA, 36, P = 0.262) or the 2nd disinfection (AP, 6; PA, 13, P = 0.157), suggesting that there is no relationship between disinfective power and the sequence of the disinfectants used. The number of positive cultures significantly decreased after the 2nd disinfection (P < 0.01), however. CONCLUSIONS: There was no significant difference in disinfective power according to sterilization sequence with 70% isopropyl alcohol and 10% PVP-I in healthy volunteers. The combination of 70% isopropyl alcohol and 10% PVP-I was more effective than disinfection with a single agent regardless of sterilization sequence.

Ophthalmopathy Induced by Bilateral Carotid Cavernous Fistula in a Patient with Graves' Disease

Graves' disease (GD) can lead to specific eye afflictions including proptosis, periorbital swelling, conjunctival injection, chemosis, and opthalmoplegia, which then become a condition called Graves' ophthalmopathy or thyroid-associated ophthalmopathy (TAO). A carotid cavernous fistula (CCF) is an abnormal vascular communication between the carotid artery and the cavernous sinus. The clinical signs of CCF are very similar to TAO and should be considered as a differential diagnosis of TAO. We would like to present an interesting case of a bilateral ophthalmopathy induced by CCF in a GD patient. A 54-year-old man with a 6-year history of GD presented with bilateral exophthalmos and conjunctival injection for two months. The orbital CT scan findings were consistent with CCF, and an angiography revealed bilateral CCF. He received a bilateral coil embolization for the CCF and his ophthalmic signs were immediately improved. We recommend orbital imaging to exclude other coexisting diseases in patients who are suspected of TAO, especially when the diagnosis is uncertain or when determining whether medical or surgical intervention is appropriate.

Ultrasound-Guided Fine-Needle Aspiration Biopsy in Infracentimetric Thyroid Nodules

PURPOSE: The aim of this study is to determine the efficacy of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules that are equal to or less than 1 cm at the maximum diameter. MATERIALS AND METHODS: The US-FNABs performed on thyroid nodules from March to August 2009 were included in this study. We retrospectively evaluated the cytopathologic results as well as any complications associated with the procedure. RESULTS: Of the 241 thyroid nodules (range: 0.1 - 1.0 cm, mean size: 5.8 mm) in 184 patients (female: male = 164:20, mean age: 49.0 years, age range: 18 - 77 years old), the incidence of an inadequate sample was 14.1% (34/241) for the US-FNABs. Eighty six nodules were surgically removed in 62 patients, of which 15 were confirmed to be benign nodules and 71 were confirmed to be malignant nodules. The number of true positive, false positive, true negative and false negative results for US-FNAB were 59, 0, 10 and 3%, respectively, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 95.2%, 100%, 100%, 76.9% and 95.8%, respectively. All the false negative cases were less than 3 mm at the maximal diameter. There were no serious complications in all the patients. CONCLUSION: US-FNAB was effective for the cases of thyroid nodule under 1 cm at the maximal diameter. However, a false negative result of US-FNAB should be considered for the cases of very small nodules that are less than 3 mm at the maximal diameter.

Differences of the Neurocognitive Function in the Specific Symptom Subgroups of Schizophrenia / 신경정신의학

OBJECTIVES: This study investigated the validity of positive-negative dichotomy model by comparing the differences of neurocognitive function in the specific symptom subgroups of schizophrenia. METHODS: Factor analysis was performed on 14 items of the Positive and Negative Syndrome Scale (PANSS) among 71 inpatients with schizophrenia. All patients were assigned to one of specific symptom subgroups based on a ratio score and compared the neurocognitive distinction of each subgroups with normal control group, which was composed of 60 healthy persons without psychiatric illness. Neurocognitive functions include sustained attention, sensory register, executive function, attention and concentration, and verbal memory and learning obtained using Degraded Stimulus Continuous Performance Test, Span Apprehension Task, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test respectively. RESULTS: Three factors, positive, negative and disorganized, were yielded from factor analysis on 14 items of the PANSS. Three symptom subgroups showed the differential neurocognitive profiles. Disorganized symptom subgroup showed significant deficits in the sustained attention, sensory register, executive function, attention and concentration, and verbal memory and learning compared with the normal controls. Negative symptom subgroup showed significant deficits in the sustained attention, sensory register, executive function, and verbal memory and learning. Positive symptom subgroup showed significant deficits only in the sustained attention and sensory register compared with the normal controls. No significant differences were noted in the sustained attention, sensory register, attention and concentration, and verbal memory and learning among three symptom subgroups. But the disorganized symptom subgroup showed a significant deficit in the executive function compared to the positive symptom subgroup. CONCLUSIONS: These results support that three symptom dimensions including disorganization may be more valid than the positive-negative symptom dichotomy in the dimensions of schizophrenic symptoms.

Arthroscopic Anterior Cruciate Ligament Reconstruction With Bone-Achilles tendon-Bone Composite Allograft

PURPOSE: We intended to evaluate the results of arthroscopic anterior cruciate ligament(ACL) reconstruction using Bone-achilles tendon-bone composite allograft by analyzing the results clinically and radiologically. MATERIALS AND METHODS: From May 1996 to June 1999, we followed 23 patients who had arthroscopic ACL reconstruction using bone-achilles tendon-bone composite allograft for minimum 24 months, and measured laxity using KT-2000 arthrometer, Lysholm score and enlargement of tibial tunnel width on plain radiograph. RESULTS: In KT-2000 arthrometer test, there was only side-to-side differences of 1.67 +/-0.7 mm between the involved and contralateral limb. Lysholm score was 61.7 +/-10.2 preoperatively and 89.3 +/-5.1 at the last follow up. And there was no tibial tunnel enlargement more than 5 mm at the last follow up. CONCLUSION: Arthroscopic ACL reconstruction using bone-achilles tendon-bone composite allograft has advantage of preservation of anatomic structure and secure bone-to-bone fixation like the bone-patel-lar tendon-bone graft that bone-achilles tendon-bone composite allograft is a reasonable choice in ACL reconstruction.

Five Cases of Primary Writing Tremor

Primary writing tremor is considered to be a task-specific tremor occurring when handwriting. We describe the clinical and electrophysiological features of 5 patients. Two of the patients had a family history of the tremor. Alcohol was effective in reducing the tremor in 3 of the patients. Two patients showed a co-contraction and three alternate contractions between agonist and antagonist muscles. The frequency of the tremors was 5 to 6 Hz. Primidone and propranolol were effective in reducing tremor. Considering the clinical and electrophysiological features, it is suggested that primary writing tremor might be a variant of essential tremor. (J Korean Neurol Assoc 19(1):52~55, 2001

Significance of Intracranial Pressure Monitoring in Early Surgery for Poor-Grade Aneurysm Patients

OBJECTIVE: Patients with poor grade aneurysm usually present with increased intracranial pressure(ICP), even those without an intracranial clot. Based on this fact, the present study investigated a significance of intracranial pressure monitoring in those patients. PATIENTS AND METHODS:A total of 60 patients with Hunt and Hess Grade IV(50 patients) or V(10 patients) were treated for aneurysmal subarachnoid hemorrhage(SAH) during a 3-year-period, and intraparenchymal ICP was measured in the majority, immediately after arrival to the emergency room. Early surgery including intraoperative ventriculostomy was undertaken within 3 days after SAH. An ultraearly surgery was performed without preceding angiogram or ICP monitoring in patients with large sylvian hematomas, highly suggestive of middle cerebral artery aneurysm. Outcomes were assessed by the Glasgow Outcome Scale(GOS) at 6 months. RESULTS: In overall, favorable outcome(GOS scores 1-2) was seen in 27(54.0%) of admission Grade IV and 1(10.0%) of admission Grade V patients. Of the 38 surgical patients with preoperative ICP monitorings, 25 patients (80.6%) exhibiting ICP values of less than 40mmHg showed favorable outcome, however, no patients with ICP values above 40mmHg recovered(Fisher's exact test, p=0.0001). CONCLUSION: It is concluded that a preoperative ICP above 40mmHg before ventriculostomy indicate significant vital brain destruction as intractable intracranial hypertension, and Grade IV patients at admission with an ICP below 40mmHg can be of benefit from early surgical intervention while Grade V patients still remains unfavorable.

Cholesterol Granuloma in the Sphenoid Sinus: A Case Report

The authors report a case of cholesterol granuloma in the sphoid sinus in 54-year old woman, which is probably the first report of cholesterol granuloma arising primarily in the sphenoid sinus apart from the petrous bone. The initial clinical presentations were unilateral decreased visual acuity and facial sensory change. The mass was removed totally via transsphenoidal route and the pathological examination revealed cholesterol clefts and chronic granulomatous changes. The differences between the present case and the previous reports are discussed.

Expression of bcl-2 and p53 Protein, and Apoptosis in Transitional Cell Carcinoma of the Bladder

This study examined the expression of the bcl-2 protein in 59 cases of transitional cell carcinomas (TCCs) of the bladder and evaluated the relationship of bcl-2 and p53 with apoptosis. The cases were divided into 41 low-grade TCCs, 18 high-grade TCCs, 32 superficial TCCs, and 27 invasive TCCs. p53 and bcl-2 protein were detected by the immunohistochemical method and apoptosis was analysed by using hematoxylin-eosin stained slide. The results were as follows: bcl-2 protein was detected in 8 (14%) TCCs and all of these cases were low grade TCCs. Expression of bcl-2 protein was not correlated with clinical stage. There was no correlation between bcl-2 and p53 protein. According to the immunohistochemical results of bcl-2 and p53 protein, the cases were divided 4 groups. Apoptotic index (AI) was higher in p53 positive/ bcl-2 negative group than other groups but the significance was recognized only between p53 positive/bcl-2 negative group and p53 negative/bcl-2 negative group (p<0.05). p53 protein was detected in 20 (36%) TCCs and its expression was correlated positively with histologic grade and clinical stage (p<0.05). AI correlated positively with histologic grade and clinical stage (p<0.01). These data indicate that overexpression of bcl-2 protein is rare in TCC of the bladder and associated with low grade TCCs. Overexpression of p53 is associated with the tumor progression in the TCCs. AI correlates with p53 positivity but does not correlate with bcl-2 positivity.

Closure of Carotid Cavernous Fistula by Manual Carotid Jugular Compression / 대한뇌혈관학회지

A patient with symptomatic dural fistula involving the cavernous sinus did intermittant external manual compression of the cervical carotid artery and jugular vein. We observed complete closure of fistula with improvement of symptoms either clinically or at angiography done 6 weeks later, and recommend this technique with clinical follow up and angiography in selected cases before more definitive therapy is employed.

Relations among Social Functioning, Psychopathology and Attentional Deficits in Schizophrenic Outpatients / 신경정신의학

In order to study the relations between attentional deficits and social functioning of the schizophrenia, 83 stable outpatients with DSM-IV schizophrenia and matched 60 normal controls were examined for their sustained attention, sensory register, and social functioning by means of Continuous performance test(CPT), Span apprehension task(SPAN), and Korean version of Social Adjustment Scale II-Revised Version(KSAS II-RV) respectively. Psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS). The results were as follows. 1) Schizophrenic patients showed a significant deficit in the sustained attention and sensory register as manifested in the data of CPT and SPAN, compared with the matched normal controls. Schizohrenic patients also showed a significantly poor social functioning in measure of KSAS II-RV compared with the matched normal controls. 2) There was no correlation between three type of symptoms(positive/negative/general) and total scores of social functioning. But negative symptoms was correlated with the social leisure subarea of KSAS II-RV. 3) CPT was correlated with total scores of social functioning including the instrumental role and friend relation subareas of KSAS II-RV, whereas SPAN was only correlated with the instrumental role subarea of social functioning. 4) In the relations between attention and symptoms, CPT was correlated with negative symptoms. These results suggest that the deficit of the sustained attention may be a predictive factor of social functioning in the schizophrenic outpatients.