Gallbladder Metastasis of Renal Cell Carcinoma: A Case Report

The gallbladder (GB) is a rare site of renal cell carcinoma (RCC) metastasis. To the best of our knowledge, only a few reports of CT findings of GB metastasis exist in the literature. Herein, we report a case of histologically proven GB metastasis of RCC in a 55-year-old male who underwent CT for an intraluminal polypoid mass simulating a primary GB lesion.

Gallbladder Metastasis of Renal Cell Carcinoma: A Case Report

The gallbladder (GB) is a rare site of renal cell carcinoma (RCC) metastasis. To the best of our knowledge, only a few reports of CT findings of GB metastasis exist in the literature. Herein, we report a case of histologically proven GB metastasis of RCC in a 55-year-old male who underwent CT for an intraluminal polypoid mass simulating a primary GB lesion.

Chlorpromazine activates p21(Waf1/Cip1) gene transcription via early growth response-1 (Egr-1) in C6 glioma cells

2-Chloro-10-[3(-dimethylamino)propyl]phenothiazinemonohydrochloride (chlorpromazine) is a phenothiazine derivative used clinically to control psychotic disorders. It also exhibits an anticancer activity. Treatment with chlorpromazine (CPZ) results in cell-cycle arrest at the G2/M phase in rat C6 glioma cells. CPZ reduces the expression of cell cycle-related proteins, such as cyclin D1, cyclin A, and cyclin B1, but causes an increase in the p21(Waf1/Cip1) level. The molecular mechanism by which CPZ regulates p21(Waf1/Cip1) expression is unknown. Here, we provide evidence that CPZ activates the p21(Waf1/Cip1) gene promoter via induction of the transcription factor early growth response-1 (Egr-1) independently of p53 in C6 cells. A point mutation in the Egr-1-binding motif within the p21(Waf1/Cip1) promoter abrogated promoter inducibility due to CPZ. Forced expression of Egr-1 enhanced p21(Waf1/Cip1) promoter activity. In contrast, knockdown of endogenous Egr-1 by small interference RNA attenuated CPZ-induced p21(Waf1/Cip1) promoter activity. A chromatin immunoprecipitation assay demonstrated that Egr-1 binds to the p21(Waf1/Cip1) gene promoter. Further analysis showed that the ERK and JNK MAP kinases are required for induction of Egr-1 by CPZ. Finally, stable silencing of Egr-1 expression lead to attenuated CPZ-inducible p21(Waf1/Cip1) expression and inhibited G2/M phase cell-cycle arrest. These results demonstrate that a functional link between ERK and JNK MAP kinase pathways and p21(Waf1/Cip1) induction via Egr-1 contributes to CPZ-induced anticancer activity in C6 glioma cells.

Transcription of the protein kinase C-delta gene is activated by JNK through c-Jun and ATF2 in response to the anticancer agent doxorubicin

Expression of protein kinase C-delta (PKC delta) is up-regulated by apoptosis-inducing stimuli. However, very little is known about the signaling pathways that control PKC delta gene transcription. In the present study, we demonstrate that JNK stimulates PKC delta gene expression via c-Jun and ATF2 in response to the anticancer agent doxorubicin (DXR) in mouse lymphocytic leukemia L1210 cells. Luciferase reporter assays showed that DXR-induced activation of the PKC delta promoter was enhanced by ectopic expression of JNK1, c-Jun, or ATF2, whereas it was strongly reduced by expression of dominant negative JNK1 or by treatment with the JNK inhibitor SP600125. Furthermore, point mutations in the core sequence of the c-Jun/ATF2 binding site suppressed DXR-induced activation of the PKC delta promoter. Our results suggest an additional role for a JNK signaling cascade in DXR-induced PKC delta gene expression.

Mismatch Negativity according to the Changes of Auditory Stimuli / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Infrequent sounds (deviant stimuli) occurring in a sequence of repetitive sounds (standard stimuli) elicit an event-related potential response called the mismatch negativity (MMN) even in the absence of attention to these sounds. The purposes of these studies are to record the MMNs elicited by the changes of auditory stimuli in stimulation rate, duration and probability in healthy adults and to record the MMNs in healthy children. SUBJECTS AND METHOD: Three studies were performed. The subjects were 15 adults in study 1, 20 adults in study 2, and 22 children in study 3. The standard stimulus was 50 msec, 750 Hz, 80 dB SPL tone burst. In study 1, the deviant stimulus was 750 Hz, 80 dB SPL tone burst, in which duration of the deviant stimulus was varied (25, 75, 100, 125, 150 msec) and stimulation rate was varied (0.9/sec, 2/sec). In study 2, the deviant stimulus was 125 msec, 750 Hz, 80 dB SPL tone burst and the probabilities of the deviant stimulus were varied (40, 35, 30, 25, 20, 15, 10, 5%). In study 3, the deviant stimulus was 125 msec, 750 Hz, 80 dB SPL tone burst and the probability of the deviant stimulus was 20%. RESULTS: We obtained stable MMNs in adults and children. The amplitude of MMN was largest when duration of the deviant stimulus, stimulation rate and probability of the deviant stimulus were 125 msec, 0.9/sec and 5% respectively. CONCLUSION: The MMNs can be obtained from healthy adults and cooperative children. The MMN could be used as an objective measure for central auditory processing and individual discrimination ability.

Implication of Egr-1 in trifluoperazine-induced growth inhibition in human U87MG glioma cells

The early growth response gene-1 (Egr-1) is a tumor suppressor which plays an important role in cell growth, differentiation and apoptosis. Egr-1 has been shown to be down-regulated in many types of tumor tissues. Trifluoperazine (TFP), a phenothiazine class of antipsychotics, restored serum-induced Egr-1 expression in several cancer cell lines. We investigated the effect of Egr-1 expression on the TFP-induced inhibition of cell growth. Ectopic expression of Egr-1 enhanced the TFP-induced antiproliferative activity and downregulated cyclin D1 level in U87MG glioma cells. Our results suggest that antipsychotics TFP exhibits antiproliferative activity through up-regulation of Egr-1.

Effect of Epitympanoplasty with Mastoid Obliteration Technique on Postoperative Rehabilitation of Hearing Impaired / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was designed to identify whether canal type hearing aids can be used by the patients who have undergone epitympanoplasty with mastoid obliteration for postoperative rehabilitation of hearing impaired and also to investigate the advantages of the complete in the canal (CIC) hearing aid for the postoperative rehabilitation of hearing impaired. SUBJECTS AND METHOD: Fourty-three ears belonging to 40 adults, who were treated by epitympanoplasty with mastoid obliteration for cholesteatoma from April 1995 to May 1999 were involved in this study. The impressions were taken and measured postoperatively by Vernier calipers anteroposteriorly (AP) and superoinferiorly (SI). It is well known that the size of the external auditory canal (EAC) should be over 7 mm in diameter and over 2 cm in length to be able to wear the CIC type hearing aid. The shape of the EAC was also taken into consideration. RESULTS: Thirty-five out of 43 ears were large enough to wear CIC hearing aids and all 43 for the canal (ITC) hearing aids. No ears were excluded from being able to wear a CIC or ITC hearing aid with respect to the shape of the EAC. CONCLUSION: Canal type hearing aides can be used after epitympanoplasty with mastoid obliteration which is used as a treatment of cholesteatoma.

Late Lung Parenchymal Changes on HRCT in Children with mycoplasma Pneumonia

PURPOSE: To evaluate late lung parenchymal change, as seen on high-resolution CT(HRCT) in children with mycoplasma pneumonia MATERIALS AND METHODS: Twenty-three patients [15 boys and 8 girls aged two to 13 (mean, 6) years] with mycoplasma pneumonia underwent HRCT four to 39 (mean, 10) months after initial infection. Using increased mycoplasma antibody titer(> 1:640) mycoplasma pneumonia was diagnosed, and patients were divided into two groups : high titer group (antibody titer>1: 5120), and lower titer group (<1:5120). CT scans were performed using 2mm collimation and 5-10mm interval from apex to diaphragm. In seven patients who were cooperative, both inspiratory and expiratory scans were obtained at a window width of 1600 HU and level of -700. HRCT findings of mosaic low attenuations and changes in bronchioles and bronchial walls were assessed by three radiologists and correlated with initial chest radiographic findings. RESULTS: On HRCT, 17 of 23 patients (74 %) demonstrated abnormal findings. These included mosaic attenuation of lung density alone in 11 of 17 patients (65%), mosaic attenuation associated with bronchiectasis in five ( 29 %), and bronchiectasis only in one (6 %). Mosaic attenuation was more accentuated on expiratory scans than on inspiratory. These findings were obtained in 10 of 12 high titer group and in 7 of 11 in the lower titer group. In 15 of 23 patients (65 %), involved ageas seen on HRCT exactly corresponded with initially involved areas seen on chest radiographs (CXR). Two patients in whom findings on initial CXR were normal showed mosaic attenuation on HRCT. Six patients in whom such findings were abnormal showed normal findings on HRCT, a fact which reflected their complete recovery. CONCLUSION: The most common late parenchymal change in mycoplasma pneumonia, as seen on HRCT, was mosaic attenuation of lung density followed by bronchiectasis. The latter is presumably due to bronchiolitis obliterans, a well-known complication. We believe that HRCT is very useful for the evaluation of long-term sequelae of mycoplasma pneumonia in children.

The Role of Multistage Maximal Exercise Test in the Evaluation of Patient for Various Heart Disease

The multistage maximal exercise test was performed to 135 cases with various heart disease and 207 control group between jan. 1980 and Dec. 1980 in KoreaGeneral Hospital. The change of heart rate, blood pressure and ST segment in various heart disease were compared with those in control group. The results were followings; 1. There were 130 male and 77 female of cases with control group, whose mean age were 50 years old. 2. General check up was the most common underlying disease of control group(67 patients) and the others were gastritis (28), neurosis (24), diabets mellitus (17), hepatitis (4) and peptic ulcer (4) frequency. 3. Change of heart rate, blood pressure and ST segment in control group during GXT were 89~154, 119/80~157/88 mmHg and 0.6~2 mm. 4. There were 81 male and 51 female of cases with various heart disease group, whose mean age were 50 years old. 5. Atherosclerotic heart disease was the most common underlying disease of various heart disease group (49 patients) and the others were hypertension (34), hypertensive cardiovascular disease (22), labile hypertension (14), angina (7), arrythmia (6) and others (3) in frequency. 6. Change of heart rate, blood pressure and ST segment in various heart disease group during GXT were 85~148, 140/93~178/102 mmHg and -0.7~1.3mm. ST segment in atherosclerotic heart disease, hypertension, hypertensive cardiovascular disease, valvular heart disease and myocardial infarction were significantly depressed(p<0.05) compared with ST segment in control group.

Echocardiographic Assessment of Cardiac Anatomy and Function in Hypertensive Patients

Cardiovascular complications are major sources of morbidity and mortality in hypertensive patients. To assess the prevalence of anatomical and functional abnormalities of the heart in such patients, we studied total 67 sujects with systemic hypertension and hypertensive cardiovascular disease by echocardiography. Accordingly normal values of echocardiography from 27 control subjects, we found each significant change(p<0.05). of the septal thickness, left ventricular mass, mitral valve E-F slope and aortic dimension on the both groups, but functional measurements did only show significant change on the hypertensive cardiovascular group in contrast to hypertensive subjects group. The prevalence of the echocardiographic abnormalities on the simple hypertensive subjects group who have no abnormal 12-lead E.C.G. or Chest X-rays are orderly 14 subjects(64%) on the aortic root dimension, 9 subjects (41%) on the left ventricular posterior free-wall thickness and 7 subjects(32%) on the septal thickness. These findings demonstrated a high prevalence of cardiac abnormalities in a population of asymptomatic hypertensive subjects. And these abnormalities can be detected well by echocardiography before they were otherwise apparent.