Increases in Doxorubicin Sensitivity and Radioiodide Uptake by Transfecting shMDR and Sodium/Iodide Symporter Gene in Cancer Cells Expressing Multidrug Resistance / 핵의학분자영상

PURPOSE: Multidrug resistance (MDR) of the cancer cells related to mdr1 gene expression can be effectively treated by selective short hairpin RNA for mdr1 gene (shMDR). Sodium/iodide symporter (NIS) gene is well known to have both reporter and therapeutic gene characteristics. We have co-transfected both shMDR and NIS gene into colon cancer cells (HCT15 cell) expressing MDR and Tc-99m sestamibi and I-125 uptake were measured. In addition, cytotoxic effects of doxorubicin and I-131 therapy were also assessed after transfection. MATERIAL AND METHODS: At first, shMDR was transfected with liposome reagent into human embryonic kidney cells (HEK293) and HCT cells. shMDR transfection was confirmed by RT-PCR and western blot analysis. Adenovirus expressing NIS (Ad-NIS) gene and shMDR (Ad-shMDR) were co-transfected with Ad-NIS into HCT15 cells. Forty-eight hours after infection, inhibition of P-gycoprotein (Pgp) function by shMDR was analyzed by a change of Tc-99m sestamibi uptake and doxorubicin cytotoxicity, and functional activity of induced NIS gene expression was assessed with I-125 uptake assay. RESULTS: In HEK293 cells transfected with shMDR, mdr1 mRNA and Pgp protein expressions were down regulated. HCT15 cells infected with 20 MOI of Ad-NIS was higher NIS protein expression than control cells. After transfection of 300 MOI of Ad-shMDR either with or without 10 MOI of Ad-NIS, uptake of Tc-99m sestamibi increased up to 1.5-fold than control cells. HCT15 cells infected with 10 MOI of Ad-NIS showed approximately 25-fold higher I-125 uptake than control cells. Cotransfection of Ad-shMDR and Ad-NIS resulted in enhanced cytotoxic by doxorubicin in HCT15 cells. I-131 treatment on HCT15 cells infected with 20 MOI of Ad-NIS revealed increased cytotoxic effect. CONCLUSION: Suppression of mdr1 gene expression, retention of Tc-99m sestamibi, enhanced doxorubicin cytotoxicity and increases in I-125 uptake were achieved in MDR expressing cancer cell by co-transfection of shMDR and NIS gene. Dual therapy with doxorubicin and radioiodine after cotransfection shMDR and NIS gene can be used to overcome MDR.

Penetration of Cefprozil into Middle Ear Effusion in Pediatric Chronic Otitis Meida with Effusion / 대한이비인후과학회지

BACKGROUND: From a pharmacokinetic standpoint, middle ear effusion (MEE) acts as a sequestered compartment since diffusion of antibiotics from serum and to this compartment is limited. The effectiveness of an antibiotic to eradicate infection within an anatomic compartment is related to both its ability to penetrate and the susceptibility of the causative pathogen. OBJECTIVE: The goal of this study was to determine the steady state plasma and MEE concentrations of cefprozil in pediatric chronic otitis media with effusion (COME). MATERIALS AND METHODS: Twenty-five children with COME were enrolled, and MEE was collected using a ventilation tube insertion after 0.5, 2, 3, 5, and 6 hours of single oral administration of 15 mg Cefprozil/kg body weight. Blood samples were also collected as soon as the MEE was collected, and analyzed in order to measure the concentration of Cefprozil using the validated high performance liquid chromatography (HPLC) method. RESULTS: The mean concentrations of cefprozil in MEE ranged from 0.4 to 4.4 ug/ml. The penetration of cefprozil into the MEE was rapid and effectively. Cefprozil in the MEE was maintained at a greater level than MIC90 in Streptococcus pneumoniae for at least 6 hours after administration of 15mg/kg. CONCLUSION: Cefprozil penetrates well into MEE in patients with pediatric COME.

Transtympanic Endoscopic Diagnosis of Perilymph Fistula / 대한이비인후과학회지

Perilymph fistula (PLF) is a disease for which diagnostic criteria have not been established yet. For this reason, at the present time, the definitive diagnosis of PIS can only be made by direct identification of perilymphatic leak during exploratory tympanotomy. But it can be difficult to distinguish between serous transudates from operative incisions and the clear fluid expected with a true fistula. Infiltrated lidocaine makes the distinction even more difficult as well. Recently, endoscopies have been used in middle ear by transtympanic or transtubal approach. However, endoscopic diagnosis of PLF in the literature is very rare. We diagnosed 2 cases of PLF by transtympanic endoscopy. Because transtympanic endoscopy did not require lidocaine infiltration nor performing a tympanomeatal flap, confirmation of perilymphatic leakage was easier. This study therefore recommends transtympanic endoscopy as one method of improving diagnosis of PLF.

Maternal and perinatal outcomes in triplet versus twin pregnancies with the result of Assisted Reproductive Technology / 대한산부인과학회잡지

The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome; 14(25.9%) vs 7(9.72%), ventilatory support; 18(33.3%) vs 5(6.9%), neonatal seizure; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.

The Controlled Study between The Group Used Highly purified FSH and The Group Used FSH/hMG in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

OBJECTIVE: It is known that normal follicular growth and pregnancy are possible using Follicular stimulating hormon(FSH) alone during controlled ovarian hyperstimulation(COH) for IVF-ET. The purpose of this study was to compare and analize the results of COH for IVF-ET between a group using only FSH-HP and a group using FSH/hMG METHOD: 111 cycle of the total 280 COH for IVF-ET cycles belonged to the FSH-HP group, and the FSH/hMG group accounted for remaining 169 cycles. The amount of gonadotropin administered, the duration of hormonal therapy, the number of embryos transfered, the endometrial thickness, and the pregnancy rate were compared between the two groups and statistically analized using the t-test. p values less than 0.05 deemed statistically significant. RESULT: There were no statistical differences on the amount of gonadotropin administered, the duration of hormone therapy, number of oocytes retrieved, nor the endometrial thickness between the two groups. However,the serum E2 level was significantly lower, and the number of embryos of high quality(GradeIandII) significantly higher in the FSH-HP group. In pregnancy rate, FSH-HP group shows higher than FSH/hMG group(38.8% VS 34.2%). but the difference was not large enough to be considered statistically significant. CONCLUSION: The results of this study show that compared to using FSH/hMG, treatment with FSH-HP alone allowed the retrieval of more embryos of high quality, and although not statistically significant, achieved a higher pregnancy rate, thus indicating that it can be used as an effective method for COH.

A Case of Blind Ending Megaureter: Preoperatively suspected of Adnexal Tumor / 대한산부인과학회잡지

A pelvic mass in women may be gynecologic in origin or it may arise from the urinary tract or bowel. Nonovarian or nongynecologic conditions may be confused with uterine or ovarian mass. The rare congenital megaureter should always be kept in mind as a possible cause of a pelvic mass. Congenital megaureter showed various clinicopathological features and frequently associated with ipsilateral or controlateral upper tract anomalies. Early meticulous imaging surgical correction will lead to excellent result. We experienced a rare case of blind ending megaureter which was suspected adnexal tumor in twenty seven-year-old woman. Here we present the case with brief review of literatures.

A Case of Primary Carcinoma of the Fallopian Tube / 대한산부인과학회잡지

Primary carcinoma of the fallopian tube is rare and accounts for less than 1% of all cancers of female genital tract. Presenting symptoms are variable and nonspecific, with preoperative diagnosis rarely entertained. The history and character of fallopian tubal carcinoma is similar to ovarian cancer, so the evaluation and treatment are also essentially the same. This case of primary fallopian tube carcinoma was confirmed postoperatively on the basis of the pathologic examination of resected specimen. We have experienced a case of primary carcinoma of fallopian tube and report with a brief review of the literatures.

Salivary and Blood Flow Responses to Different Frequency Stimulation of the Cervical Sympathetic Nerve of the Submandibular Gland in the Cat / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It has been assumed that salivary glands receive secretory fibers both from parasympathetic and sympathetic nerves. In fact, however, the existence of sympathetic secretory fibers in the cervical sympathetic nerve has not been established yet, because the salivary response to the cervical sympathetic stimulation is variable and short-lasting, and it tends to cease in spite of continued stimulation. This study investigated whether or not the cervical sympathetic nerve contains specific secretory fibers. MATERIALS AND METHODS: Salivary and blood flow responses to different frequency stimulation of the cervical sympathetic nerve, and often some autonomic drugs administration were observed from the submandibular gland in chloralose-anesthetized cats. RESULTS: 1) Low frequency stimulation (1-2 Hz) of the sympathetic nerve did not evoke salivary outflow and any change of blood flow, whereas high frequency stimulation of the nerve evoked salivary outflow and decrease of blood flow, in which salivary response tended to cease in spite of continued stimulation. 2) The salivary and blood flow responses to high frequency stimulation (20 Hz) of the nerve were not affected by the intravenous administration of propranolol, but were abolished by regitine. 3) Noradrenalin evoked salivary outflow and decreased blood flow which were not affected by the administration of propranolol but were abolished by regitine. 4) Isoproterenol increased blood flow but did not evoke salivary outflow, and the blood flow response was abolished by propranolol. CONCLUSION: These results suggest that the cervical sympathetic nerve does not contain specific secretory fibers and salivary outflow response to high frequency stimulation of the nerve may be due to either excitation of motor fibers innervating contractile elements of the excretory duct or chemical transmitters released from the vasomotor fibers.