A Mechanism for the Up-regulation of the IL-8 Gene Expression in Keratinocytes by All-trans Retinoic Acid / 대한피부과학회지

BACKGROUND: Retinoic acid (RA) has been reported to induce the up-regulation of inflammatory cytokines such as IL-1, TNF-alpha and IL-8 in dermal fibroblasts and keratinocytes. There is no evidence to support a direct interaction between the RA-mediated transcriptional machinery and IL-8 gene transcription. OBJECTIVE: The aim of this study is to clarify the mechanism of the up-regulation of IL-8 in keratinocytes by RA. METHODS: The IL-1, IL-8, TNF-alpha and MCP-1 mRNA expressions in HaCaT cells stimulated by RA were measured by quantitative RT-PCR. The effects of a NF-kappaB inhibitor and IL-1 receptor antagonist (ra) on the IL-8 mRNA expression were measured by quantitative RT-PCR. Electrophoretic motility shift assay (EMSA) was conducted on the RA-stimulated HaCaT cells that were or were not treated with NF-kappaB inhibitor to measure the NF-kappaB binding activity in each group. The phospho-IkappaB activity in the HaCaT cells after stimulation with RA was also measured by Western blotting. RESULTS: An up-regulation of the IL-8 gene expression by RA was demonstrated in the HaCaT cells. The inhibition assay revealed the involvement of the NF-kappaB binding site of the IL-8 gene in the RA-enhanced promoter activity. EMSA demonstrated that RA enhanced the formation of the DNA-NF-kappaB complex. There was no evidence to support IL-1 as an intermediate stimulus between the RA-mediated transcriptional machinery and IL-8 gene transcription. Western blot analysis revealed increased phospho-IkappaB activity in the HaCaT cells after stimulation with RA. CONCLUSION: Our result suggested that the IL-8 gene expression of HaCaT cells after RA stimulation is caused by the activation of IKK and the dissociation of IkappaB from NF-kappaB and the transcription of NF-kappaB in the nucleus.

Safety and Efficacy of Colonoscopic Tattooing of a Colorectal Neoplasm Prior to a Laparoscopic Resection

PURPOSE: Accurate tumor localization prior to a laparoscopic surgical resection is the critical. India ink tattoos properly placed in the colorectum are long lasting and have been reported to probably remain constantly in previous studies. The present study was done to review the safety and reliability of colonoscopic tattooing prior to a laparoscopic resection of a colorectal neoplasm. METHODS: Between May 2003 and August 2004, 20 patients underwent colonoscopic tattooing of a colorectal neoplasm prior to laparoscopic surgery. The clinical data were retrospectively reviewed. RESULTS: Among the 20 patients, 14 (70%) had tumors located in the sigmoid colon, 4 (20%) had tumors in the rectosigmoid junction, and 1 had a tumor (5%) in the upper rectum and descending colon. In six patients (30%) who had received an endoscopic mucosal resection (EMR), an additional surgical resection was required to remove the tumor completely, and those 6 patients needed another preoperative colonoscopy for India ink tattooing. The median time between tattooing and resection was 2 days (range: 1 to 18 days). Tattoos were visualized intraoperatively and localized the tumor accurately in 15 patients (75%). Seven patients underwent intraoperative colonoscopy; five didn't have tattoos that could be visualized intraoperatively, and two patients with visible tattoos needed intraoperative colonoscopy to confirm the site of tumor. Only one patient (5%) had mild fever with abdominal discomfort, which were relieved by hydration and administration of intravenous antibiotics for one day. CONCLUSIONS: A colorectal neoplasm can be localized with an acceptable reliability by using preoperative colonoscopic tattooing. India ink tattooing at the time of the EMR may reduce unnecessary colonoscopies if we doubt a complete resection has been achieved by using an EMR. The complications following colonoscopic tattooing were minimal.

Anatomical Relationship of the Anterior Ethmoid Canal to the Anterior Skull Base: A Computed Tomographic Analysis on the Types of the Fovea Ethmoidalis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: As the anterior ethmoid canal (AEC) provides a good surgical landmark and its injury may result in serious complications, the anatomical relationship of the AEC to the anterior skull base (ASB) should be evaluated preoperatively. Despite some studies on the ASB, studies analyzing this anatomical relationship and the types of the fovea ethmoidalis (FE) on computed tomography (CT) are rare. The aim of this study is to better understand this anatomical relationship by determining the frequency of each type of the FE and distances between anatomical structures on the CT scans with our new classification. MATERIALS AND METHOD: Four hundred sides of the FE were analyzed from the preoperative coronal CT scans of 200 chronic sinusitis patients (100 males and 100 females, aged 20 to 59 years). The FE was classified into 4 types (I: non-separated type, II: partially separated type, III: completely separated type, IV: unidentifiable type) and 2 subtypes (A: developed medial cranial wall, B: undeveloped medial cranial wall). Heights of the medial cranial wall (a), the AEC (b), and the ethmoid roof (c) were measured on the CT image. RESULTS: Frequencies of the types I-IV were 48.0% (IA: 25.2%, IB: 22.8%), 19.3% (IIA: 4.3%, IIB: 15.0%), 29.5% (IIIA: 29.5%, IIIB: 0%), and 3.2%, respectively. The medial cranial wall of type IIIA was significantly longer than those of the other types, and the AEC of type IIIA was in a significantly lower position than those of the other types. CONCLUSION: On the CT scans, we found the AEC in 96.8% and type IIIA in nearly 30% of all types of the FE. Sinus surgery should be performed only after preoperative evaluation of these anatomical relationship on the CT scans under close scrutiny. For the type IIIA, surgery should be performed with utmost care due to high risk of injury to the AEC and the medial cranial wall.