Expressions of Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-2 with Changes of Interleukin-6 and Interleukin-18 in Atherosclerotic Lesions of Hypercholesterolemic Rabbits / 대한흉부외과학회지

BACKGROUND: Atherosclerosis is a chronic inflammatory disease of the arterial wall characterized by progressive accumulation of lipids,cells,and extracellular matrix.Matrix metalloproteinases(MMPs)and tissue inhibitor of metalloproteinases(TIMPs)contribute to vascular matrix remodeling in atherosclerosis,and some cytokines may play role in the synthesis or activation of MMPs or TIMPs. MATERIALS AND METHOD: We produced experimental atherosclerotic plaques in 9 rabbits by atherogenic hypercholesterol diet for 12 weeks,and 10 other rabbits were used as control group with standard laboratory chow.At that time,19 rabbits were sacrificed and aorta,coronary arteries and blood specimens were prepared.The expressions of MMP-9,TIMP-2 and interleukin(IL)-18,and the bioactivity of IL-6 were investigated with H&E stain,immunohistochemical stain,immunoblotting(Western blot analysis),and bioassay. RESULT: Serum cholesterol in the experimental group increased up to 1258 +/-262 mg/dL(control group:41 +/-7 mg/dL).All experimental group showed well developed atherosclerotic plaques in aorta and coronary artery.The expression of MMP-9 in aorta and coronary artery of the experimental group showed significant increase than that of the control group by immunohistochemistry.Among the experimental group, complicated lesions with intimal rupture or complete luminal occlusion,demonstrated stronger expression of MMP-9.Interestingly,there was no difference in expression of TIMP-2 between the experimental and the control group.These findings were confirmed by Western blot analysis.The bioassay revealed significant up-regulation of serum bioactivity of IL-6 in the experimental group(4819.60 +/-2021.25 IU/ml)compared to that of IL-6 in the control group(27.20 +/-12.19 IU/ml).IL-18 was expressed in all atherosclerotic plaques, whereas little or no expression was detected in the control group. CONCLUSION: The increased MMP-9 expression along with the unchanged TIMP-2 expression seem to be contributory factors in extracellular matrix degradation in atherosclerosis.Focal overexpression of MMP-9 may promote plaque destabilization and cause complications of atherosclerotic plaques such as thrombosis with/without acute coronary syndrome.Elevation of IL-6 and IL-18 may be more than just markers of atherosclerosis but actual participants in lesion development.Identification of critical regulatory pathway is important to improve the understanding of the cellular and molecular basis of atherosclerosis and may open the way for novel therapeutic strategies.

A Moderate Case of Hemolytic Disease in a Newborn Caused by Anti-M Antibody / 대한임상병리학회지

Anti-M antibodies are usually assumed to be naturally occurring and to consist of immunoglobulin M reacting at 4degrees C. They are not usually considered to be clinically significant, however, many of them have an immunoglobulin G component reacting at 37degrees C and can be correlated with hemolytic disease of the newborn (HDN). We report a moderate case of HDN by anti-M. A 2-days old baby born from a mother with preeclampsia as a second pregnancy was admitted due to anemia, hyperbilirubinemia and hypoxic encephalopathy. The blood type of mother was AB, ccDEE, NN, and the blood type of baby was A, D+, and MN. Antibody screening and identification identified anti-M antibody which was strong reactive at 37degrees C albumin and antiglobulin phase in both baby's and her mother's serum. The direct antiglobulin test of baby's red blood cells was negative. The infant was transfused with group O red cells which have negative to trace reaction with her mother's serum in antiglobulin phase. Two days later, the hemoglobin level elevated from 6.7 g/dL to 15.9 g/dL falled to below 11 g/dL quite soon. After all, newborn died of cardiac arrest due to her basic disease at age of 49 days; metabolic acidosis and hypernatremia.

Recurrent Solitary Fibrous Tumor of the Mediastinum / 대한흉부외과학회지

Solitary fibrous tumors of the serosal cavities are rare and usually occur in the visceral or parietal pleura, but they have also been observed in the mediastinum, pericardium, peritoneum, lung parenchyma, orbit, and the meninges. The histological variability of these tumors may contribute to the difficulty in diagnosing these neoplasms, especially when they arise in the mediastinum and extrathoracic sites. The clinical behavior of the tumor is unpredictable. Some tumors that appear histologically benign may behave aggressively. The incidence of aggressive behavior is variously reported as between 13 and 23% of cases in most large series. This report is a case review in a 53-year-old female patient who had re-excision of histologically benign, recurrent solitary fibrous tumor, 1, 6, 11, and 14 years after the initial operation.

Clinical Analysis for Thymic Carcinoma / 대한흉부외과학회지

BACKGROUND: Thymic carcinoma is a very rare disease and treatment modality is not standardized. So, we report our experience of management of thymic carcinoma. MATERIAL AND METHOD: Between 1984 and 1998, eight patients with thymic carcinoma were treated at Keimyung University Dongsan Medical center. RESULT: The median age was 46 years with a range of 23 to 67 years. Chief complaint was a anterior chest pain. Histologic subtypes included two lymphoepithelioma-like carcinoma, two squamous cell carcinoma, one basaloid carcinoma, and three mixed type. Clinical staging was classified to stage I in 2, stage II in 4, stage III in 1, and stage IVA in 1 according to the modified Masaoka staging system. Four patients underwent complete resection and three patients were found to have incomplete resection by histologic evaluation. One patient underwent only biopsy due to pericardial dissemination and invasion of adjacent organ. All patients had adjuvant chemotherapy, radiation therapy was administered to five patients for positive resection margin and above stage III. The median follow up period was 55.3+/-64.6 months, three patiants died and four patients are alive without recurrence. One patient in recurrence had two times re-operations and adjuvant chemoradiotherapy. He is still alive. CONCLUSION: We concluded that completely surgical resection and adequate adjuvant chemoradiotherapy after early diagnosis are useful to management of thymic carcinoma.

Primary Fibrosarcoma of the Lung with Spontaneous Hemothorax / 대한흉부외과학회지

Primary pulmonary sarcoma is a rare tumor at all ages. It may be present as a solitary nodule or huge tumor of the thoracic cavity and frequently remain asymptomatic until growing large. A 50-year-old woman who presented sudden chest pain was found to have spontaneous hemothorax. The right upper lobectomy with lymph node dissection was performed, the pathologic result was pulmonary fibrosarcoma.

Antioxidative Effect of Ginseng Saponin on Cardiac Endothelial Cells in Culture / 대한해부학회지

The cytotoxic effects of oxygen free radicals and the antioxidative effect of ginseng saponin (SPN) on cardiac endothelial cell cultures derived from 3-day old rats were studied. Reactive oxygen species were generated by hypoxanthine (HX) and xanthine oxidase (XO) mixture to the culture medium. Exposure of cardiac endothelial cells to this oxygen-radical-generating system resulted in significant time-dependent decrease of MTT activity and increase of lactate dehydrogenase (LDH) release. These results correlated well with the morphological examination of randomly selected cultured cardiac endothelial cells, which showed large cytoplasmic vacuoles, disordered organelles, pronounced increase of endoplasmic reticular swelling, and decreased maintenance of membrane integrity. The decrease in cell viability and increase of LDH release induced by the oxygen free radicals in cardiac endothelial cell cultures were blocked during the first two hours by antioxidants such as ginseng saponin (SPN), deferoxamine (DFX), and ginseng saponin/deferoxamine mixture (SPN/DFX). These antioxidative effects were significantly greater in the SPN-treated group than in the other antioxidant-treated groups. Especially, the cells of the SPN-treated group showed well developed cytoskeletons, which enabled them to firmly attach to the culture vessel. In conclusion, these results indicate that ginseng saponin has a significant antioxidative effect on cardiac endothelial cells in culture and plays an important role in stimulating the formation of cytoskeleton and maintaining the integrity of cell membrane.

Reoperations for prosthetic valve replacement / 대한흉부외과학회지

No abstract available.