KR-31831, a new synthetic anti-ischemic agent, inhibits in vivo and in vitro angiogenesis

Angiogenesis is considered to be an integral process to the growth and spread of solid tumors. Anti-angiogenesis therapy recently has been found to be one of the most promising anti-cancer therapeutic strategies. In this study, we provide several lines of evidences showing that KR-31831, a new benzopyran derivative, has anti-angiogenic activities. KR-31831 inhibited the proliferation, migration, invasion and tube formation of bovine aortic endothelial cells (BAECs), and suppressed the release of matrix metalloproteinase-2 (MMP-2) of BAECs. KR-31831 also inhibited in vivo angiogenesis in mouse Matrigel plug assay. Furthermore, the mRNA expressions of basic fibroblast growth factor (bFGF), fibroblast growth factor receptor-2 (FGFR-2), and vascular endothelial growth factor receptor-2 (VEGFR-2) were decreased by KR-31831. Taken together, these results suggest that KR-31831 acts as a novel angiogenesis inhibitor and might be useful for treating hypervascularized cancers.

Radiographic Evaluation on the Forefoot: Based on the Two Different Data (1982 and 2004) / 대한족부족관절학회지

PURPOSE: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. MATERIALS AND METHODS: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. RESULTS: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. CONCLUSION: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.

Radiographic Evaluation on the Forefoot: Based on the Two Different Data (1982 and 2004) / 대한족부족관절학회지

PURPOSE: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. MATERIALS AND METHODS: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. RESULTS: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. CONCLUSION: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.

Aortic Root Reconstruction for Aortic Insufficiency Developed after Fontan Operation / 대한흉부외과학회지

Aortic regurgitation in the pediatrics who had previous cardiac surgery is increased with their improved longterm survival rate and their complexity of heart disease. So the need of aortic valve surgery in pediatrics is also on the increase. A 10-year old boy was admitted for progressive cyanosis and dyspnea on exertion(DOE). The patient had been underwent lateral tunnel Fontan operation before. Echocardiography and cardiac catheterization study revealed hepatic vein drained to pulmonary atrium via intrahepatic collaterals, moderate atrioventricular regurgitation, and severe aortic regurgitation due to aortic root dilation. We report a case who had aortic root reconstruction, valvuloplasty of the atrioventricular valve, and hepatic vein ligation successfully. Cyanosis and DOE was dramatically improved after the operation

Dual Stent Application on Congenital Tracheobronchial Stenosis / 대한흉부외과학회지

We report successful application of dual tracheobronchial stent to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with CO2 retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stent. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty. Finally we applied dual tracheobronchial stent and resolved the airway obstruction.

Prevalence of Leptospira interrogans in Wild Rodents in Korea

Leptospirosis has been known as endemic disease in Korea since 1984. Wild rodent, mostly Apodemus agrarius, has been known as an important source of leptospiral infection especially in rainy circumstances in harvest reason of rural area. The infection rates of Leptospira interrogans in field rodents, Apodemus agrarius, was investigated by culture and PCR detection of leptospiral DNA, and compared with previous data. Furthermore, the serogroup and serovar were investigated. Two hundred twenty two Apodemus agrarius were captured during October to December 1996. Spirohaetes were isolated from 22 (9.9%) and leptospiral DNA was detected in an additional six rodents (12.6%). Subsequent cross-agglutinin absorption test, monoclonal antibody reactivity classified 21 cultures among 22 isolates as Leptospira interrogans serogroup Icterohemorrhagiae serovar lai. The above data did not differ from previous survey in 1984 to 1987. There was no significant change of Leptospira interrogans infection in field rodents in Korea.

A Case of Broncho-esophageal fistula associated with Bronchiectasis / 결핵

Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment. To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

Occlusion o Left Middle Cerebral Artery Manifested as Disseminated Intravascular Coagulation

This report dealt with the case of 58 year old male with thrombotic thrombocytopenic purpura syndrome. The patient had an occlusion of the left middle cerebral artery on the carotid angiogram. The clinical course of the case with disseminated intravascular coagulation was fulminant. Literatures on pathophysiology, treatment, pathology and clinical course disseminated intravascular coagulation were reviewed.

An Analysis of the Result of Surgical Treatment of Anterior Communicating Aneurysms

The authors attempted to analyse the factors influencing the mortality involved in aneurysm surgery based on 38 cases of intracranial surgery for anterior communicating aneurysms, and obtained the following conclusion. 1. The surgical results are much better when the aneurysm surgery is delayed over one week after the occurrence of aneurysmal rupture, if there is no evidence of intracerebral hematoma. Administration of a massive dosage of epsilon aminocaproic acid in the waiting period prior to aneurysm surgery seems to be effective for preventing recurrence of bleeding from the aneurysm. 2. The direction of the anterior communicating aneurysm should be clearly visualized on a cerebral angiogram so that the most effective aneurysmal approach can be selected in surgery. 3. Microsurgery and hypotension in aneurysm surgery minimize brain damage in the exposure of aneurysm and provide accurate isolation of the aneurismal neck from the parent vessel in aneurysmal neck ligation. 4. Proximal ligation of the anterior cerebral artery is also an effective procedure to prevent recurrent hemorrhage from anterior communicating aneurysm.