Convulsion Due to Meningoencephalitis in Hepatitis a Virus Infection

Hepatitis A virus (HAV) infection usually has a self-limited clinical course and sometimes remains subclinical. HAV infection rarely causes neurologic problems. There are only a few case reports on seizure and meningoencephalitis associated with serologically confirmed hepatitis A infection. We report a case of a 27-year-old man admitted to the emergency department due to confusion after an episode of generalised tonic convulsion. Laboratory test results included AST 441 units/L and ALT 1294 units/L. A diagnosis of hepatitis A was confirmed by the finding of serum IgM-HAV antibody. HAV infection should be considered one of the aetiologies of meningoencephalitis.

Low-dose intra-arterial urokinase and aggressive mechanical clot disruption for acute ischemic stroke after failure of intravenous thrombolysis

BACKGROUND AND PURPOSE

Intravenous (IV) thrombolysis often fails to achieve recanalization of occluded cerebral arteries, especially in patients with proximal large arterial occlusions. The goal of this study was to assess the feasibility, safety, and efficacy of low-dose intra-arterial (IA) urokinase and aggressive mechanical clot disruption (AMCD) after failure of IV thrombolysis for acute ischemic stroke.

MATERIALS AND METHODS

We prospectively enrolled 12 patients with acute ischemic stroke who initially received IV recombinant tissue plasminogen activator (rtPA) and were subsequently treated with combined low-dose IA urokinase and AMCD. Time to treatment, urokinase dose, duration of the procedure, recanalization rates, and symptomatic hemorrhage were analyzed. Clinical outcome measures were assessed on admission and at discharge (National Institutes of Health Stroke Scale [NIHSS]), and at 3 months after treatment (modified Rankin Scale [mRS]).

RESULTS

Median NIHSS score on admission was 17. Median time from symptom onset to IV rtPA was 120 minutes, and median time from symptom onset to IA therapy was 230 minutes. The median duration of IA therapy was 55 minutes. Median dose of urokinase was 300,000 U. Recanalization (thrombolysis in cerebral ischemia grade II or III) was achieved in all patients. No procedure-related complications were observed. There was no symptomatic hemorrhage. At discharge, median NIHSS score was 3. The 3-month outcome was excellent (mRS, 0-1) in 8 patients, good (mRS, 2) in 1 patient, and poor (mRS, 3-5) in 3 patients. There was no hospital or 3-month mortality.

CONCLUSIONS

In this study, combination therapy with low-dose IA urokinase and AMCD is safe and effective after failed IV thrombolysis in patients with acute ischemic stroke. A high rate of recanalization, low rate of symptomatic hemorrhage, and excellent functional outcome can be achieved.

Acute exposure of human skin to ultraviolet or infrared radiation or heat stimuli increases mast cell numbers and tryptase expression in human skin in vivo

BACKGROUND

Mast cells are key effector cells in diverse immunological and pathological processes. It is still unclear why there are more mast cells at peripheral and sun-exposed skin sites than at sun-protected sites.

OBJECTIVES

To investigate changes in mast cell numbers associated with natural ageing and photoageing, and to observe the effects of ultraviolet (UV) and infrared (IR) radiation and heat on the prevalence of mast cells and tryptase expression in human skin in vivo.

METHODS

Sun-exposed and sun-protected skin samples were taken from individuals in four different age groups. UV, IR or heat-treated buttock skin of young volunteers was also obtained. Mast cells were quantified by immunohistochemical staining of mast cell-specific tryptase and chymase. The expression of tryptase was determined by Western blotting.

RESULTS

Both sun-exposed and sun-protected skin showed a gradual decrease in total mast cells (MC(Total)) number with ageing. The number of mast cells in sun-exposed skin was significantly higher than that in sun-protected skin. After UV irradiation (2 minimal erythema doses), MC(Total) and mast cells expressing tryptase and chymase were significantly increased at 24 and 48 h postirradiation. After IR irradiation (3 minimal heating doses) and heat treatment (43 degrees C for 90 min), MC(Total) reached peak induction at 8 and 48 h after stimulation, respectively. Tryptase expression was also clearly upregulated by UV, IR and heat.

CONCLUSIONS

Our data demonstrate that mast cell numbers decreased with ageing in human skin. Also, mast cells may be activated and recruited by UV, IR and heat. These findings should further our understanding of the reason for the high prevalence of mast cells at peripheral sun-exposed skin sites.

Treatment of vertebral artery dissecting aneurysms presenting with progressive myelopathy

Two patients with vertebral artery dissecting aneurysm are presented in which the posterior inferior cerebellar artery (PICA) arose from the wall of the aneurysm. The patients presented with progressive myelopathy due to mass effect on the medulla. One patient was treated with proximal occlusion of the vertebral artery using Guglielmi detachable coils (GDCs). The other patient underwent complete excision of the aneurysm, with reimplantation of the PICA into the vertebral artery proximal to the dissecting aneurysm. We obtained good results with improvement of myelopathy in both patients, but the patient who underwent bypass surgery suffered longstanding palsy of the lower cranial nerves. This report emphasizes that complete aneurysm clipping or excision for such patients is the gold standard of treatment, but preservation of PICA flow may require technically sophisticated surgical techniques. However, even if the aneurysm is not completely eliminated, the myelopathy can be dramatically improved with conservative endovascular treatment with proximal occlusion. Therefore, the choices for treatment in such lesions varies with the angiographic findings, degrees of mass effect on the brainstem, and the patient's physical condition.

Human hair growth enhancement in vitro by green tea epigallocatechin-3-gallate (EGCG)

Green tea is a popular worldwide beverage, and its potential beneficial effects such as anti-cancer and anti-oxidant properties are believed to be mediated by epigallocatechin-3-gallate (EGCG), a major constituent of polyphenols. Recently, it was reported that EGCG might be useful in the prevention or treatment of androgenetic alopecia by selectively inhibiting 5alpha-reductase activity. However, no report has been issued to date on the effect of EGCG on human hair growth. This study was undertaken to measure the effect of EGCG on hair growth in vitro and to investigate its effect on human dermal papilla cells (DPCs) in vivo and in vitro. EGCG promoted hair growth in hair follicles ex vivo culture and the proliferation of cultured DPCs. The growth stimulation of DPCs by EGCG in vitro may be mediated through the upregulations of phosphorylated Erk and Akt and by an increase in the ratio of Bcl-2/Bax ratio. Similar results were also obtained in in vivo dermal papillae of human scalps. Thus, we suggest that EGCG stimulates human hair growth through these dual proliferative and anti-apoptotic effects on DPCs.

Reverse engineering of gene regulatory networks

Systems biology is a multi-disciplinary approach to the study of the interactions of various cellular mechanisms and cellular components. Owing to the development of new technologies that simultaneously measure the expression of genetic information, systems biological studies involving gene interactions are increasingly prominent. In this regard, reconstructing gene regulatory networks (GRNs) forms the basis for the dynamical analysis of gene interactions and related effects on cellular control pathways. Various approaches of inferring GRNs from gene expression profiles and biological information, including machine learning approaches, have been reviewed, with a brief introduction of DNA microarray experiments as typical tools for measuring levels of messenger ribonucleic acid (mRNA) expression. In particular, the inference methods are classified according to the required input information, and the main idea of each method is elucidated by comparing its advantages and disadvantages with respect to the other methods. In addition, recent developments in this field are introduced and discussions on the challenges and opportunities for future research are provided.

The clinical values of squamous cell carcinoma antigen and carcinoembryonic antigen in patients with cervical cancer treated with concurrent chemoradiotherapy

The objective of this study was to determine the prognostic significance of the pre- and posttreatment serum levels of the squamous cell carcinoma antigen (SCC-Ag) and carcinoembryonic antigen (CEA). From 2001 to 2005, 211 patients were treated with concurrent chemoradiotherapy (CCRT). The SCC-Ag and CEA levels were measured before treatment, 1 month after treatment, and during the follow-up. The association between the pretreatment tumor marker levels and the clinical prognostic factors was evaluated. The frequency of complete remission (CR) and the normalization of the posttreatment tumor marker were also analyzed. The pretreatment serum levels of CEA and SCC-Ag were elevated in 68 (32.2%) and 148 (70.1%) patients, respectively. The number of patients with an elevated pretreatment SCC-Ag level was associated with the FIGO stage, tumor volume, and pelvic lymph node status. The pretreatment CEA was only significantly related to the tumor volume and pelvic lymph node involvement. One month after completing CCRT, the CEA and SCC-Ag levels were normalized in almost all patients with an incidence of 88.2% (60/68) and 93.2% (138/148), respectively. Among the patients who gained CR with a previously elevated pretreatment CEA and SCC-Ag, the values were normalized in 92.1% (58/63) and 96.4% (134/139) at 1 month, respectively. Combination assays of the pre- and posttreatment serum CEA and SCC-Ag levels appear to be useful for both predicting the prognosis and estimating the clinical response in cervical cancer. However, the routine combined measurement with SCC-Ag of CEA in all patients had limited additional effect in predicting the prognostic significance.

Stromelysin-3 expression in the differential diagnosis of dermatofibroma and dermatofibrosarcoma protuberans: comparison with factor XIIIa and CD34

BACKGROUND

The distinction between dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP) is a well-known challenge for dermatopathologists. Immunohistochemical stains have been used to augment routine histological examination to aid in differentiating DF from DFSP. Stromelysin-3 (ST3) is a member of the matrix metalloproteinase (MMP) family, MMP-11, which is expressed in the skin during wound healing and in the stroma of basal cell carcinoma. Recent studies demonstrated that DFs expressed ST3, whereas DFSPs were only rarely ST3 positive.

OBJECTIVES

To assess the expression of ST3 in DF and DFSP and to ascertain whether ST3 is superior to factor XIIIa or CD34 in differentiating DF from DFSP, by comparison with factor XIIIa and CD34 expression.

METHODS

Immunohistochemical staining was performed on 23 cases of DF and 17 cases of DFSP, using antibodies to ST3, factor XIIIa and CD34.

RESULTS

ST3 was expressed in all cases of DF (23 of 23) but only one case showed weakly positive staining in DFSP (one of 17). The mean +/- SD ST3 immunohistochemistry (IHC) score in DF was 4.52 +/- 0.67. The sensitivity of ST3 was 100% and the specificity was 94%. Factor XIIIa was expressed in all cases of DF (23 of 23) and in five of the 17 DFSPs. The mean +/- SD factor XIIIa IHC score in the DFs was 4.43 +/- 0.73. The sensitivity of factor XIIIa was 100% and the specificity was 71%. CD34 was expressed in four of the 23 DFs and 16 of the 17 DFSPs. The mean +/- SD CD34 IHC score in the DFSPs was 4.41 +/- 1.37. The sensitivity of CD34 was 94% and the specificity was 83%.

CONCLUSIONS

Immunohistochemical staining with a commercial anti-ST3 antibody can be successfully carried out in routine dermatopathology. We confirmed that ST3 is a positive marker for DF and that ST3 staining might be more reliable than factor XIIIa staining in differential diagnosis of DF and DFSP. As the present study showed that ST3 was not absolutely negative in all cases of DFSP, the combination with CD34 immunostaining could make the distinction more reliable.

Infrared exposure induces an angiogenic switch in human skin that is partially mediated by heat

BACKGROUND

Angiogenesis plays an important role in physiological and pathological conditions of the skin. Although acute ultraviolet-induced skin angiogenesis has been investigated, little is known about the distinct effects of acute infrared (IR) radiation on angiogenesis in human skin.

OBJECTIVES

To elucidate the molecular regulation of the angiogenic switch by acute near-IR radiation or by a single heat treatment in human skin in vivo.

METHODS

We subjected 16 healthy volunteers to near-IR irradiation (six minimal heating doses) and 14 healthy volunteers to heat treatment (43 degrees C for 90 min), and skin specimens were obtained by punch biopsy for immunohistochemical, Western blot and reverse transcription-polymerase chain reaction analyses.

RESULTS

We observed that CD31-stained vessels in the upper dermis were increased after acute near-IR exposure, and that this was associated with the upregulation of vascular endothelial growth factor (VEGF) and the downregulation of thrombospondin (TSP)-2. During the application of near-IR to buttock skin, skin temperatures immediately increased from 32 degrees C up to 42 degrees C, as measured using a digital thermometer. Moreover, the expression of inducible heat shock protein 70 was increased after near-IR irradiation in human skin. Therefore, we investigated the effects of a single heat treatment on angiogenesis and on the expression of VEGF and TSP-2 in skin, and found that vascularization and VEGF expression were increased, whereas TSP-2 expression was reduced.

CONCLUSIONS

Our results suggest that IR radiation plays an important role in skin angiogenesis via regulation of the balance between the angiogenic inducer VEGF and the angiogenic inhibitor TSP-2, and that IR-induced skin angiogenesis might be partially caused by the effects of heat in human skin in vivo.

A Caucasian male with very low blood cholesterol and low apoA-II without evidence of atherosclerosis

BACKGROUND

It is well known that a high level of apolipoprotein (apo) A-II can be associated with familial combined hyperlipidaemia, and that high apolipoprotein profiles can contribute to the development of atherosclerosis. The serum lipoprotein/apolipoprotein profile of a Caucasian patient who had unusually low serum total cholesterol (83 mg dL(-1)) and triglyceride (28 mg dL(-1)) levels despite a high body mass index (33.5 kg m(-2)), is the subject of this report.

MATERIALS AND METHODS

Each lipoprotein was isolated from serum by sequential ultracentrifugation, and serum and lipoprotein lipids and proteins were determined. The cholesteryl ester (CE) conversion ability of lecithin:cholesterol acyltransferase and CE transfer activity of CE transfer protein were assayed, and the composition of apolipoprotein and lipoprotein(-1) was analyzed by electrophoresis and Western blot analysis.

RESULTS

Electrophoresis and immunodetection analyses revealed a 60% decrease in the apoA-II band intensity compared to normal reference serum. The decreased apoA-II was associated with reduced very low density lipoprotein-cholesterol and protein content, as well as a greater high-density lipoprotein (HDL)(2) size with high cholesterol content. The CE conversion activity and CE transfer activity of HDL(3) were almost totally lacking in the hypolipidaemic serum, although the expression level of lecithin:cholesterol acyltransferase was normal. Electron microscopy revealed that the obese patient had larger HDL(2) and HDL(3) particle sizes than those of reference serum.

CONCLUSION

These results suggest that a decreased apoA-II protein in serum and increased HDL-cholesterol and particle size might protect against hyperlipidaemia and the atherosclerotic process, even in a patient with severe obesity.

Phenylpropanolamine contained in cold remedies and risk of hemorrhagic stroke

In this study, we sought to elucidate whether phenylpropanolamine (PPA) in cold remedies (small and divided doses) increases the risk of hemorrhagic stroke (HS). PPA exposure significantly increased the risk, and the risk was much higher in women. In women, linear trends were also found in recency, duration, and dosage of PPA exposure. PPA contained in cold remedies increases the risk of HS, particularly in women.

Non-traumatic peroneal nerve palsy: MRI findings

AIM

To present magnetic resonance imaging (MRI) findings of non-traumatic peroneal nerve palsy and to evaluate the usefulness of MRI in patients with non-traumatic peroneal nerve palsy.

MATERIALS AND METHODS

In a retrospective study, 11 consecutive patients presenting with peroneal nerve palsy were included. MR images of the lower leg and electrophysiological examinations were also reviewed. The cause of peroneal nerve palsy was determined on the basis of MRI findings and was evaluated using electrophysiological data. Nine patients with causative lesions detected on MRI, underwent surgery.

RESULTS

Clinical examination and electromyography (EMG) disclosed 11 peroneal lesions. MRI and EMG revealed three types of signal intensity change, i.e. deep peroneal nerve palsy type, common peroneal nerve palsy type, and superficial peroneal nerve palsy type. The MRI and EMG findings were in agreement in seven (65%) of the 11 study patients. In nine patients the causative lesions were identified using MRI, including ganglion cyst (n=6), osteochondroma (n=1), synovial cyst (n=1), and aneurysm (n=1).

CONCLUSION

Ganglion cyst is the most common cause of non-traumatic peroneal nerve palsy. MRI offers a noninvasive method for obtaining useful information to assess, localize, and monitor peripheral peroneal nerve palsy.

ApoA-I mutants V156K and R173C promote anti-inflammatory function and antioxidant activities

BACKGROUND

Two mutants of apolipoprotein (apo) A-I, V156K and A158E, showed markedly different structural and functional properties in lipid-free and lipid-bound states in the authors' earlier report. The physiological activities of these mutants were compared with the wild-type (WT) and R173C mutant using in vitro and in vivo experiments.

MATERIALS AND METHODS

A reconstituted high-density lipoprotein (rHDL) with palmitoyloleoyl phosphatidylcholine (POPC), combined with each of the apoA-I variants, was injected into the tail-veins of hypercholesterolaemic mice (C57BL6/J), which had been fed a high cholesterol and high fat (HCHF; 0.5% cholesterol, 15% lard, 0.1% sodium cholate) diet for 23 weeks, once at 0 h and then every 24 h, at a dosage of 30 mg apoA-I kg(-1) of body-weight.

RESULTS

The V156K-rHDL and R173C-rHDL exhibited significantly stronger anti-oxidant activity against copper-mediated low-density lipoprotein (LDL) oxidation than did A158E in an apolipoprotein state. The mice injected with WT-rHDL or A158E-rHDL showed abrupt increases in total cholesterol concentrations (47% and 38%, respectively) as compared with the levels before injection, whereas the mice injected with V156K-rHDL and R173C-rHDL did not. Injection with V156K-rHDL improved serum lipids and anti-oxidative activities compared with the injection of WT-rHDL. Injection of WT-rHDL or A158E-rHDL increased serum interleukin-6 (IL-6) to 90-110 pg mL(-1), whereas the injection of V156K-rHDL or R173C-rHDL increased serum IL-6 to 17-25 pg mL(-1) only.

CONCLUSION

The V156K-rHDL and R173C-rHDL displayed potent beneficial effects, including anti-oxidant and anti-inflammatory activity from both in vitro and in vivo evaluations, whereas the WT-rHDL and A158E-rHDL did not.

Deterministic modelling and stochastic simulation of biochemical pathways using MATLAB

The analysis of complex biochemical networks is conducted in two popular conceptual frameworks for modelling. The deterministic approach requires the solution of ordinary differential equations (ODEs, reaction rate equations) with concentrations as continuous state variables. The stochastic approach involves the simulation of differential-difference equations (chemical master equations, CMEs) with probabilities as variables. This is to generate counts of molecules for chemical species as realisations of random variables drawn from the probability distribution described by the CMEs. Although there are numerous tools available, many of them free, the modelling and simulation environment MATLAB is widely used in the physical and engineering sciences. We describe a collection of MATLAB functions to construct and solve ODEs for deterministic simulation and to implement realisations of CMEs for stochastic simulation using advanced MATLAB coding (Release 14). The program was successfully applied to pathway models from the literature for both cases. The results were compared to implementations using alternative tools for dynamic modelling and simulation of biochemical networks. The aim is to provide a concise set of MATLAB functions that encourage the experimentation with systems biology models. All the script files are available from www.sbi.uni-rostock.de/ publications_matlab-paper.html.

Changes in gastric endocrine cells in Balb/c mice bearing CT-26 carcinoma cells: an immunohistochemical study

The distribution and density of gastric endocrine cells in Balb/c mice bearing CT-26 carcinoma cells were studied immunohistochemically employing specific antisera against serotonin, somatostatin, glucagon, gastrin, cholecystokinin (CCK)-8 and human pancreatic polypeptide (hPP). The animals were divided into two groups, a non-implanted sham group and a CT-26 carcinoma cell-implanted group. Samples were collected from two regions of the stomach (fundus and pylorus) at 28 days after implantation of the medium or the CT-26 cells (1x10(5) cells/mouse). Five of the 6 types of immunoreactive (IR) cells were identified, with only the hPP IR cells not being detected. The regional distribution of the gastric endocrine cells in the CT-26 implanted group was similar to that of the non-implanted sham group. However, the endocrine cells were significantly decreased in the CT-26-implanted group as compared to those of the non-implanted sham group. Serotonin- and somatostatin-IR cells in the fundus and pylorus , and gastrin- and CCK-8-IR cells in the pylorus of the CT-26 implanted groups were significantly decreased compared to those of the sham group. In addition, glucagon-IR cells were restricted only to the fundus of the sham animals. hPP-IR cells were not detected in either the T-26 implanted- or the non-implanted group. Since endocrine cells are the anatomical units responsible for the production of gut hormones, a change in their density may reflect a change in their capacity to produce such hormones. Implantation of the tumor cell mass induced severe quantitative changes in gastric endocrine cell density, an abnormality which may contribute to the development of gastrointestinal symptoms, such as anorexia and indigestion, frequently encountered in cancer patients.

Ethnic characteristics of eyelashes: a comparative analysis in Asian and Caucasian females

BACKGROUND

Despite similar biochemical composition of human hair between races, physico-morphological characteristics are not identical in different ethnic groups. Eyelashes have been investigated far less than scalp hair, and the information available is insufficient.

OBJECTIVES

To obtain basic information about eyelashes and to clarify differences between female eyelashes in Asians and Caucasians.

METHODS

Twenty Asian and 10 white Caucasian female volunteers aged between 20 and 29 years were admitted to the study. Lateral digital photographs of upper eyelashes were taken and curl-up and lift-up angles of upper eyelashes were measured from lateral views. Images of upper eyelashes were also taken using the phototrichogram technique and total numbers, lengths and thicknesses of upper eyelashes were obtained (a total of 4661 eyelashes; 2946 for Asian, 1715 for Caucasian). The central portion of the eyelashes or whole eyelashes were clipped and images were taken immediately and 7 days later to obtain the growth rate and anagen ratio of upper eyelashes. Numbers and thickness of eyelash cuticular layers were obtained by electron microscopy.

RESULTS

Compared with Caucasians, Asian eyelashes revealed lower lift-up and curl-up angles, fewer numbers and a thicker transverse diameter. However, no statistical difference was observed in length or growth rate. Duration of anagen was estimated at about 2 months. The eyelash anagen ratio obtained from five Asians was 17.8 +/- 3.3%. By electron microscopy, the number of cuticular layers in transverse section was greater in Asian (8.0 +/- 1.2) than Caucasian females (6.5 +/- 1.1), but no statistical difference was found in single cuticle layer thickness between the two groups. Moreover, eyelash characteristics were not influenced by eye makeup in either race.

CONCLUSIONS

Our results on eyelash morphology and growth characteristics demonstrated significant ethnic differences in Asian and Caucasian females that could provide basic information for future investigations.

Inhibition of human cytochrome P450 isoforms and NADPH-CYP reductase in vitro by 15 herbal medicines, including Epimedii herba

OBJECTIVE

We evaluated the potential of 15 herbal medicines (HMs), commonly used in Korea, to inhibit the catalytic activities of several cytochrome P450 (CYP) isoforms and microsomal NADPH-CYP reductase.

METHODS

The abilities of 1-1000 microg/mL of freeze-dried aqueous extracts of 15 HMs to inhibit phenacetin O-deethylation (CYP1A2), tolbutamide 4-methylhydroxylation (CYP2C9), S-mephenytoin 4'-hydroxylation (CYP2C19), dextromethorphan O-demethylation (CYP2D6), chlorzoxazone 6-hydroxylation (CYP2E1), midazolam 1-hydroxylation (CYP3A4) and NADPH-CYP reductase were tested using human liver microsomes.

RESULTS

The HMs Epimedii herba, Glycyrrhizae radix and Leonuri herba inhibited one or more of the CYP isoforms or NADPH-CYP reductase. Of the three HMs, Epimedii herba extracts were the most potent inhibitors of several CYP isoforms (IC(50) 67.5 microg/mL for CYP2C19, 104.8 microg/mL for CYP2E1, 110.9 microg/mL for CYP2C9, 121.9 microg/mL for CYP3A4, 157.8 microg/mL for CYP2D6 and 168.7 microg/mL for CYP1A2) and NADPH-CYP reductase (IC(50) 185.9 microg/mL ).

CONCLUSION

These results suggest that some of the HMs used in Korea have the potential to inhibit CYP isoforms in vitro. Although the plasma concentrations of the active constituents of the HMs were not determined, some herbs could cause clinically significant interactions because the usual doses of those individual herbs are several grams of freeze-dried extracts. Controlled trials to test the significance of these results are necessary.

Mechanism of histone deacetylase inhibitor Trichostatin A induced apoptosis in human osteosarcoma cells

Although histone deacetylase (HDAC) inhibitors are emerging as a promising new treatment strategy in malignancy, how they exert their effect on osteosarcoama cells is as yet unclear. This study was undertaken to investigate the underlying mechanism of a HDAC inhibitor Trichostatin A (TSA)-induced apoptosis in a osteosarcoma cell line HOS. We observed that TSA treatment decreased the viability of the cells and prominently increased acetylation of histone H3. Evidence was obtained indicating that TSA induced apoptosis of HOS cells as follows: (1) Generation of DNA fragmentation; (2) activation of procaspase-3; (3) cleavage of PARP; and (4) increase of DNA hypoploidy. The reduction of MMP and the release of cytochrome c to cytosol were also shown, indicating that TSA induces apoptosis in HOS cells in a histone acetylation- and mitochondria-dependent fashions. We also examined whether TSA can sensitize HOS cells to the action of an antitumor agent genistein. The combination therapy of TSA and genistein showed synergistic anticancer effect indicating that TSA can be considered as a novel therapeutic strategy for osteosarcoma not only from its direct apoptosis-inducing activity but also from the possibility of sensitization to other antitumor agents.

Successful treatment of dandruff with 1.5% ciclopirox olamine shampoo in Korea

BACKGROUND

Dandruff is a chronic scalp condition characterized by scaling. The common causative agent is now accepted to be the lipophilic yeast Malassezia furfur. Ketoconazole, a highly effective antifungal agent against M. furfur has been used for the treatment of dandruff.

AIM

To determine whether a 1.5% ciclopirox olamine shampoo is as effective as a 2% ketoconazole shampoo for the treatment of mild to moderate dandruff.

METHODS

A total of 64 patients, with mild to moderate dandruff, participated in the study. The study consisted of three consecutive phases: a 2-week washout period, a 4-week treatment period and a 2-week post-treatment period. Patients were randomized equally to either the 1.5% ciclopirox olamine shampoo or 2% ketoconazole shampoo. An overall dandruff score was calculated using an area of dandruff involvement score and a severity score. Patients evaluated the presence of pruritus and also reported a global evaluation of efficacy.

RESULTS

In all, 57 patients successfully completed all three phases. The overall dandruff score declined progressively throughout the treatment period for both shampoos. A slight increase in pruritus was observed in the ciclopirox olamine treatment group during the post-treatment phase. Regarding global self-assessment of efficacy, both treatment groups were pleased with their scalp condition following treatment.

CONCLUSION

Ciclopirox olamine shampoo appears to offer an effective, safe and easy to use treatment for mild to moderate dandruff.

Effects of Jaoga-Yukmiwon®, a Korean herbal medicine, on chondrocyte proliferation and longitudinal bone growth in adolescent male rats

Externally visible growth of the body is the result of proliferation of chondrocytes and longitudinal bone growth. The effects of the Korean herbal medicine, Jaoga-Yukmiwon((R)), on the growth of adolescent rats were investigated in the present study. The proliferation ratio of chondrocytes was calculated from 5-bromo-2'-deoxyuridine incorporation during DNA synthesis. The 5-bromo-2'-deoxyuridine incorporation ratio of the control group was 21.1 +/- 3.5%, and Jaoga-Yukmiwon((R)) administration markedly increased the ratio to 34.5 +/- 4.6% (p < 0.05). The bone formation rate of longitudinal bone was estimated by labelling with tetracycline, which binds to newly formed bone. The bone formation rate in the tibia of Jaoga-Yukmiwon((R))-administered rats was increased to 405.1 +/- 4.3 micro m (p < 0.05) from 292.2 +/- 11.8 micrometer (control value). The height of the growth plate in the administrated rats was increased to 614.6 +/- 10.0 micro m (p < 0.05) from 552.3 +/- 17.1 micro m. The bone morphogenetic protein-2 immunostaining in the growth plate was also increased. These results suggest that Jaoga-Yukmiwon((R)) may promote longitudinal bone growth during the developmental period.

Primary clear cell sarcoma of bone

Clear cell sarcoma is a rare soft tissue sarcoma of young adults with melanocytic differentiation. It occurs predominantly in the soft tissue of extremities, typically involving tendons and aponeuroses. Primary clear cell sarcoma of bone is extremely rare. We report a case of primary clear cell sarcoma of the right first metatarsal in a 48-year-old woman and provide a literature review of the entity.

A fatal case of Vibrio vulnificus meningoencephalitis

The objective of this paper is to report a rare case of Vibrio vulnificus presenting as meningoencephalitis without a wound infection. Vibrio vulnificus is capable of causing severe and often fatal infections in susceptible individuals. It commonly causes necrotizing wound infections, primary septicemia, and gastroenteritis. A 69-year-old man had meningoencephalitis with lesion on the red nucleus, substantia nigra, basal ganglia, and dentate nucleus as the initial clinical manifestation of a V. vulnificus infection. This is the first case of V. vulnificus infection in which MRI demonstrated the involvement of deep nuclei of the brain.

Cutaneous metastasis to the scalp from squamous cell carcinoma of the cervix

Carcinoma of the cervix is a common neoplasm. Early detection and improved treatment techniques have resulted in better control of cancer and longer survival, however, invasive and metastatic disease still occur. Cervical cancer usually spreads through direct local extension and via the lymphatics, haematogenous metastasis is relatively infrequent and cutaneous metastases are very rare. Metastasis to the scalp is extremely rare and only three cases of scalp metastasis from cervical cancer have been reported in the literature. We now report a patient with cervical cancer who presented with metastasis to this very unusual site.

Imaging features of ischial bursitis with an emphasis on ultrasonography

OBJECTIVE

The aim of this study was to evaluate the imaging features of ischial bursitis with an emphasis on ultrasonography (US).

DESIGN AND PATIENTS

Our study included 31 patients with a painful mass or tenderness in their buttock who underwent US (n=27), CT (n=1), or MR imaging (n=4). A needle aspiration (n=6) or a bursal excision (n=5) was performed in those patients who had no clinical improvement in spite of the conservative treatment. Evaluation included lesion location, size, wall of the bursae, and intrinsic characteristics on US, CT and MR imaging.

RESULTS

Ischial bursitis was superficial to the ischial tuberosity in all patients (n=31). The lesion ranged from 1.5 cm to 7 cm (average 3.8 cm) in diameter. The bursal wall was identifiable in 25 cases (81%). Internal septa and mural nodules were seen in 12 (39%) and 17 cases (55%), respectively. Sonography showed that fluid within the bursa was hypoechoic (59%), hyperechoic (26%), or of mixed echogenicity (15%). The bursae were compressible by the transducer. Power Doppler examination (n=7) showed hypervascularity of the bursal wall. All lesions imaged with contrast-enhanced CT and MR imaging had an enhancing thin wall and mural nodule.

CONCLUSIONS

Ischial bursitis, superficial to the ischial tuberosity, can be clearly demonstrated on sonography and appears as a thin-walled cystic lesion, with or without internal septa and mural nodules.

Acute effects of UVB radiation on the proliferation and differentiation of keratinocytes

PURPOSE

The effects of UVB radiation on the proliferation and differentiation of epidermal keratinocytes were investigated with respect to timing, dosage, and repeated exposures.

METHODS

Nine healthy volunteers were placed into three subgroups and exposed to UVB radiation on buttock skin using a Waldmann UV 800 unit fitted with Philips TL-20W/12 fluorescent lamps. Three volunteers were given 2 MED of UVB and biopsied at: pre-exposure, 24, 48 and 72 h after UVB exposure. For three volunteers, 1 MED, 2 MED, 3 MED of UVB were applied. After 48 h, biopsies were taken from non-irradiated and irradiated sites. Finally, three volunteers received 1 MED of UVB daily for 5 days, and the non-irradiated and irradiated sites were biopsied 48 h after the final exposure. The expression of proliferation and differentiation markers by keratinocytes were detected by immunohistochemical staining, and the results were analysed quantitatively by image analysis.

RESULTS

The expression of proliferation and differentiation markers was observed prominently 48 h after irradiation. Higher doses of UVB caused an increase in proliferation and differentiation marker expression. Repeated exposures potentiated the effect of UVB radiation.

CONCLUSION

UVB irradiation concomitantly promotes epidermal proliferation and differentiation. Responses were maximal 48 h after irradiation. This effect of UVB increases linearly according to dose and repetition.

Effects of uwhangchungsimwon on cell viability, proliferation, and gene expression of human neuronal cell line IMR32

Uwhangchungsimwon (pill, UC) is one of the traditional Korean medical prescriptions that has been most frequently used for stroke. To characterize the effects of UC on human neuronal cells, the human neuroblastoma cell line IMR32 was treated with UC, and cell viability, cell proliferation, apoptosis, and gene expression were analyzed. The effect of UC on recovery of cell viability was analyzed following stress induction by nutrient depletion or cold shock. Flow cytometric analysis of the cell cycle showed that UC inhibits cell cycle progression of IMR32 in a dose- and time-dependent manner. UC was also identified to increase cell viability and suppress apoptosis induction by a DNA-damaging agent, etoposide. Quantitative RT-PCR analysis revealed that expressions of the p53 tumor suppressor gene and its downstream effect, Waf1, are stimulated whereas expressions of positive cell cycle regulators, c-Myc, c-Fos, and Cyclin D1 were repressed by UC treatment. Moreover, while expression levels of apoptosis inhibitors, Bcl-2 and Bcl-XL were increased following UC treatment, that of an apoptosis promoter, Bax, was decreased. In addition, expression of BMP-7, which has been recently demonstrated to improve the motor neuron recovery from stroke, was induced by UC while it was not detected in untreated cells. Taken together, our data suggest that the pharmacoclinical effects of UC might be derived in part from its negative regulation of cell proliferation and apoptosis through the transcriptional control of related genes.

Does the extent of surgery have an impact on the survival of patients who receive postoperative radiation therapy for supratentorial low-grade gliomas?

We evaluate the impact of extent of surgery (EOS) on survival of patients with supratentorial nonpilocytic low-grade gliomas (LGG) treated with postoperative radiation therapy (PORT). Sixty-five patients with pathologically confirmed supratentorial nonpilocytic LGG (36 astrocytomas and 29 oligodendrogliomas) were treated with PORT after different extents of surgery: 12 gross total resections (GTR), 27 minimal or subtotal resections (MR/SR), and 26 biopsies (B). EOS was confirmed with postoperative imaging. The median radiation dose delivered was 5,940 cGy (range, 4,950-6,620 cGy). One of 12 patients (8%) in the GTR group and 12 of 53 patients (23%) in the less than GTR group demonstrated contrast enhancement. The median follow-up was 61 months (range 5-194 month). The 10-year overall survival (OS) was 82.5% and 32% for the GTR and the less than GTR groups, respectively (P = 0.0008). The corresponding 10-year disease-specific survival (DSS) was 90% and 41.4%%, respectively (P = 0.001). Multivariate analysis showed that only contrast enhancement and EOS were predictors for OS and DSS. Our data suggest that EOS correlates with OS and DSS in patients who have PORT. GTR should be the goal if technically achievable without causing significant morbidity, and its combination with PORT is compatible with long-term survival.

Taurine intake and excretion in patients undergoing long term enteral nutrition

The purpose of this study was to investigate whether serum concentration and urinary excretion of taurine are influenced by marginal taurine intake. Twenty one male patients (75 to 95 years old), suffering from coronary heart disease, multiple cerebral infarction, cancer, subdural hematoma or respiratory failure were grouped according to duration of tube feeding (group one, 5.9 +/- 2.9; group two, 14.8 +/- 2.3; group three 48.0 +/- 22.7, mean +/- SD, months). The mean intake of taurine was 347.0 +/- 25.6, 339.8 +/- 25.6 and 337.1 +/- 259 micromol/day (mean +/- SEM) in group one, two and three, respectively. The fasting serum taurine levels were 106.5 +/- 9.6, 95.0 +/- 9.9 and 56.8 +/- 11.0 micromol/L (mean +/- SEM) in group one, two and three, respectively. Taurine level in group three patients was significantly lower than that of group one and two (p<0.05). The twenty-four hour urinary taurine excretion was 776.1 +/- 176.7, 782.4 +/- 245.3 and 388.3 +/- 169.3 micromol/day (mean +/- SEM) in group one, two and three, respectively. These results suggest that marginal taurine intake in patients receiving long term tube feeding could result in taurine deficiency.

Cytological observation of two environmental genic male-sterile lines of rice

We report here two environmental genic male-sterilities (EGMS) in rice. These two EGMS rice lines, thermo-sensitive genic male-sterility (TGMS) and photoperiod-sensitive genic male-sterility (PGMS), are controlled by temperature and photoperiod, respectively, in determining their male-sterility. Male-sterility of the TGMS and PGMS was found to be induced when they were grown at 32 degrees C/26 degrees C (day/night) with 14 h daylight, while they were fertile at 26 degrees C/20 degrees C (day/night) with 10 h daylight in a growth chamber. We also examined their anther structures under a light microscope. The light microscopic observation revealed that the EGMS lines showed a complete pollen abortion at the sterile growth condition while they produced normal fertile pollens at the fertile growth condition.

Single dose radiation is more effective for the UV-induced activation and proliferation of melanocytes than fractionated dose radiation

PURPOSE

To establish whether the effect of fractionating radiation modifies the effects of ultraviolet (UV) radiation on epidermal melanocytes, we compared the clinical and histological effects of single high dose radiation against repeated intermediate to low dose radiation on epidermal melanocytes.

METHODS

Three minimal erythema UV doses (MED) were administered to three sites on the buttocks of healthy volunteers. One site was irradiated with 0.5 MED UV every day for 6 consecutive days, another site was irradiated with 1 MED UV every second day, and a third site received a single dose of radiation with 3 MED UV. The treatment was replicated on the other buttock. For the evaluation of UV-induced erythema and pigmentation, erythema and melanin indices were measured at 2 and 14 days post-irradiation. For purposes of histological evaluation, tissue specimens taken from each irradiated site at 2 and 14 days post-irradiation and were stained with monoclonal antibodies against Mel-5, HMB-45 and tyrosinase. Fontana-Masson silver staining, DOPA staining and split DOPA reactions were also performed.

RESULTS

At 14 days post-irradiation, UV radiation induced melanocyte activation, proliferation and melanogenesis in proportion to the radiation dose administered to each fraction. The most prominent responses were observed after single high doses of radiation.

CONCLUSION

When the total administered dose is identical, fractionation of radiation dose diminishes the effects of UV radiation on epidermal melanocytes. Furthermore, long, uninterrupted doses of UV radiation were found to more effective in inducing melanogenesis and melanocyte activation.

Digitizing pediatric chest radiographs: comparison of low-cost, commercial off-the-shelf technologies

OBJECTIVE

To compare low-cost, off-the-shelf technology for digitizing pediatric chest radiographs.

MATERIALS AND METHODS

Forty pediatric chest radiographs (hard copy), each with a single abnormality, were digitized using a commercial film digitizer and two low-cost

METHODS

a digital camera and a flatbed scanner. A stratified, randomized, block design was used where 20 readers evaluated 40 different images to determine the ability to accurately detect the abnormality. Readers then rated all 160 images (40 images x 4 methods) for conspicuity of the abnormality and overall image quality.

RESULTS

Abnormalities were correctly identified on 82.3 % of hard copy images, 82.9 % of flatbed scanner images, 74.3 % of film digitizer images, and 69.7 % of digital camera images (p < 0.05) when compared to hard copy or flatbed scanner images. Lesion conspicuity was rated higher on hard copy (p < 0.05) than all digitized images. Conspicuity ratings were similar for flatbed scanner and film digitizer images, but lower in digital camera images (p < 0.05). For overall image quality, all were rated significantly different from each other (p < 0.05), with hard copy > flatbed scanner > film digitizer > digital camera images.

CONCLUSION

A low-cost flatbed scanner yielded digital pediatric chest images which were significantly superior to digital camera images While flatbed scanner images were interpreted with the equivalent diagnostic accuracy of hard copy images, they were rated lower for image quality and lesion conspicuity.

Biochemical analysis of interactions between outer membrane proteins that contribute to starch utilization by Bacteroides thetaiotaomicron

An early step in the utilization of starch by Bacteroides thetaiotaomicron is the binding of starch to the bacterial surface. Four starch-associated outer membrane proteins of B. thetaiotaomicron that have no starch-degrading activity have been identified. Two of these, SusC and SusD, have been shown by genetic analysis to be required for starch binding. In this study, we provide the first biochemical evidence that these two proteins interact physically with each other. Both formaldehyde cross-linking and nondenaturing gel electrophoresis experiments showed that SusC and SusD interact to form a complex. Two other proteins encoded by genes in the same operon, SusE and SusF, proved not to be essential for starch utilization and actually decreased starch binding when they were present along with SusC and SusD. Consistent with this, nondenaturing gel analysis revealed that in a strain producing SusC, SusD, and SusE, the SusCD complex was partially destabilized. The strain producing SusC, SusD, and SusE also grew more slowly on starch than a strain producing SusC, SusD, SusE, and SusF (mu(max), 0.29 and 0.37/h, respectively). Thus, SusE appears to interact with the SusCD complex. SusE also interacts with SusF, because SusE was less susceptible to proteinase K digestion when SusF was present, and nondenaturing gel analysis detected a complex formed by these two proteins. Our results indicate that SusC, SusD, SusE, and SusF form a protein complex in the outer membrane but that SusE and SusF are dispensable members of this complex.

New regulatory gene that contributes to control of Bacteroides thetaiotaomicron starch utilization genes

Bacteroides thetaiotaomicron uses starch as a source of carbon and energy. Early steps in the pathway of starch utilization, such as starch binding and starch hydrolysis, are encoded by sus genes, which have been characterized previously. The sus structural genes are expressed only if cells are grown in medium containing maltose or higher oligomers of glucose. Regulation of the sus structural genes is mediated by SusR, an activator that is encoded by a gene located next to the sus structural genes. A strain with a disruption in susR cannot grow on starch but can still grow on maltose and maltotriose. A search for transposon-generated mutants that could not grow on maltose and maltotriose unexpectedly located a gene, designated malR, which regulates expression of an alpha-glucosidase not controlled by SusR. Although a disruption in susR did not affect expression of the malR controlled gene, a disruption in malR reduced expression of the sus structural genes. Thus, MalR appears to participate with SusR in regulation of the sus genes. Results of transcriptional fusion assays and reverse transcription-PCR experiments showed that malR is expressed constitutively. Moreover, multiple copies of malR provided on a plasmid (5 to 10 copies per cell) more than doubled the amount of alpha-glucosidase activity in cell extracts. Our results demonstrate that the starch utilization system of B. thetaiotaomicron is controlled on at least two levels by the regulatory proteins SusR and MalR.

Inhibition of microsomal ATPases by high concentration of Mg2+ in tracheal epithelial cells

Previous work in our laboratory established the presence of two types of microsomal ATPases, a low-affinity vanadate-sensitive (LAVS) and a high-affinity vanadate-sensitive (HAVS) ATPases, in tracheal epithelial cells. These ATPases were identified as Ca2+-ATPases by specific inhibitors and microsomal Ca2+ uptakes. Since the regulatory roles of Mg2+ on both cellular Ca2+-signaling and epithelial transports were demonstrated, the effects of Mg2+ on these ATPases were investigated. Mg2+-dependence of ATPase activity appeared bell-shaped with a maximal activity at 1-2 mM Mg2+ and Mg2+ at higher than 2 mM inhibited these enzymes. In a kinetic analysis of the LAVS ATPase inhibition, high concentration of Mg2+ appeared to inhibit the binding of ATP to a substrate-binding site. The microsomal 45Ca2+ uptakes mediated by both ATPases were also inhibited by high concentration of Mg2+. In order to test whether high concentration of Mg2+ directly inhibits these enzymes, microsomes were made leaky by the treatment of Triton X-100 and the microsomal ATPases were solubilized with CHAPS. The leaky microsomal ATPases and CHAPS-solubilized ATPases were similarly inhibited by high concentration of Mg2+, suggesting that Mg2+ directly inhibit these enzymes. In conclusion, Mg2+ has two types of modulatory effects on these enzymes, a catalytic effect at low concentration and an inhibitory effect at high concentration.

Modulation of skin collagen metabolism in aged and photoaged human skin in vivo

To the best of our knowledge, no study has been conducted to date to directly compare the collagen metabolism of photoaged and naturally aged human skin. In this study, we compared collagen synthesis, matrix metalloproteinase-1 levels, and gelatinase activity of sun-exposed and sun-protected skin of both young and old subjects. Using northern blot analysis, immunohistochemical stain, and Western blot analysis, we demonstrated that the levels of procollagen type I mRNA and protein in photoaged and naturally aged human skin in vivo are significantly lower than those of young skin. Furthermore, we demonstrated, by northern blot analysis, that the procollagen alpha1(I) mRNA expression of photoaged skin is much greater than that of sun-protected skin in the same individual. In situ hybridization and immunohistochemical stain were used to show that the expression of type I procollagen mRNA and protein in the fibroblasts of photoaged skin is greater than for naturally aged skin. In addition, it was found, by Western blot analysis using protein extracted from the dermal tissues, that the level of procollagen type I protein in photoaged skin is lower than that of naturally aged skin. The level of matrix metalloproteinase-1 protein and the activity of matrix metalloproteinase-2 were higher in the dermis of photoaged skin than in naturally aged skin. Our results suggest that the natural aging process decreases collagen synthesis and increases the expression of matrix metalloproteinases, whereas photoaging results in an increase of collagen synthesis and greater matrix metalloproteinase expression in human skin in vivo. Thus, the balance between collagen synthesis and degradation leading to collagen deficiency is different in photoaged and naturally aged skin.

Aging- and photoaging-dependent changes of enzymic and nonenzymic antioxidants in the epidermis and dermis of human skin in vivo

This is a comprehensive study of the changes in major antioxidant enzymes and antioxidant molecules during intrinsic aging and photoaging processes in the epidermis and dermis of human skin in vivo. We show that the activities of superoxide dismutase and glutathione peroxidase are not changed during these processes in human skin in vivo. Interestingly, the activity of catalase was significantly increased in the epidermis of photoaged (163%) and naturally aged (118%) skin (n = 9), but it was significantly lower in the dermis of photoaged (67% of the young skin level) and naturally aged (55%) skin compared with young (n = 7) skin. The activity of glutathione reductase was significantly higher (121%) in naturally aged epidermis. The concentration of alpha-tocopherol was significantly lower in the epidermis of photoaged (56% of young skin level) and aged (61%) skin, but this was not found to be the case in the dermis. Ascorbic acid levels were lower in both epidermis (69% and 61%) and dermis (63% and 70%) of photoaged and naturally aged skin, respectively. Gluta thione concentrations were also lower. Uric acid did not show any significant changes. Our results suggest that the components of the antioxidant defense system in human skin are probably regulated in a complex manner during the intrinsic aging and photoaging processes.

Organization and developmental expression of the mosquito vitellogenin receptor gene

Vitellogenin is a precursor of the major yolk protein, vitellin. It is internalized by developing oocytes via receptor-mediated endocytosis. Previously, we characterized the vitellogenin receptor (VgR) from oocytes of the mosquito Aedes aegypti [Sappington, T.W., Kokoza,V.A., Cho,W.L. and Raikhel,A.S. (1996) Molecular characterization of the mosquito vitellogenin receptor reveals unexpected high homology to the Drosophila yolk protein receptor. Proc Natl Acad Sci USA 93: 8934-8939]. The VgR receptor has a unique structure with two putative ligand-binding domains. In order to understand the regulation of this important molecule, we characterized the VgR gene structure and its expression during vitellogenesis in the mosquito A. aegypti. We report here that the VgR gene was separated by five introns that have an average length of 60 bp, except for the second intron which was more than 20 kb long. Most introns were located within the coding regions of the first protein domain. We isolated two allelic variations of the VgR gene, VgR1 and VgR2, the nucleotide sequences of which differing only in their 5'-flanking regions. Considering their frequency in the mosquito genome, VgR2 appeared to be a major allele. The expression of VgR mRNA was studied by the Northern blot analysis and in situ hybridization. The level of the VgR transcript started to rise in the ovary one day post-eclosion. It continued its dramatic rise during the vitellogenic period, reaching its peak at 24 h PBM. The VgR transcript was present exclusively in ovaries where it was seen in oocytes and nurse cells of primary follicles and germ-line cells of the germarium.

Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color

BACKGROUND

Severe wrinkles and pigmentary changes of the exposed skin indicate substantial damage due to UV radiation. Many investigators believe that the principal manifestation of photodamage in Asians is pigmentary change rather than wrinkles. However, to our knowledge, no well-designed study has investigated the characteristics of cutaneous photodamage in Asian skin.

OBJECTIVE

To access the severity of wrinkles and dyspigmentation in Koreans exposed to sun and who smoked.

METHODS

We developed new photographic scales for grading wrinkles and dyspigmentation in 407 Koreans to assess the severity of the wrinkles and dyspigmentation. We interviewed subjects to determine cumulative sun exposure and smoking history, and measured the skin color of individual subjects.

RESULTS

Our photographic scales provided a reliable evaluation of photodamage severity in Koreans. The pattern of wrinkling in both sexes is similar, but women tended to have more severe wrinkles (prevalence odds ratio, 3.7). However, the pattern of dyspigmentation differed between the sexes. Seborrheic keratosis is the major pigmentary lesion in men, whereas hyperpigmented macules are the prominent features in women. Cigarette smoking is an independent risk factor for wrinkles, but not for dyspigmentation, in Koreans, and causes additive detrimental effects to wrinkles induced by aging and sun exposure. The constitutive skin color did not show any correlation with wrinkles or dyspigmentation. However, facultative pigmentation (sun exposure index) may reflect lifetime sun exposure, and it shows a good correlation with wrinkles in Koreans.

CONCLUSION

Wrinkling is a major feature of photoaging in Koreans, as are pigmentary changes; smoking, sun exposure, and female sex are independent risk factors for wrinkles.

Ultraviolet radiation increases tropoelastin mRNA expression in the epidermis of human skin in vivo

Photoaged skin contains elastotic materials in the upper reticular dermis. This phenomenon is commonly known as solar elastosis. Little is known about the mechanisms leading to the accumulation of elastotic materials in photoaged skin, however. In this study, it was demonstrated that ultraviolet irradiation induced tropoelastin mRNA expression in the keratinocytes of human skin in vivo and also in cultured human keratinocytes by in situ hybridization and reverse transcriptase polymerase chain reaction. It was also shown by northern blot analysis (n = 5) that there were increased tropoelastin mRNA levels in the forearm (sun-exposed) skin of elderly persons, compared with upper-inner arm (sun-protected) skin of the same individuals. As demonstrated by in situ hybridization compared to sun-protected skin (upper-inner arm) (n = 5), tropoelastin mRNA expression in photoaged skin was higher in keratinocytes as well as in fibroblasts. Therefore, our results suggest that keratinocytes are another source of tropoelastin production after acute and chronic ultraviolet irradiation in human skin in vivo.

5-fluorouracil-induced leukoencephalopathy in patients with breast cancer

The purpose of this study is to determine the characteristic clinical features, radiologic findings, and precipitating and prognostic factors in the patients with breast cancer and with 5-Fluorouracil (5-FU)-induced leukoencephalopathy. We reviewed the medical records of six breast cancer patients who developed leukoencephalopathy after chemotherapy which included 5-FU and also evaluated thorough neurological examinations including mini-mental status examination, cerebrospinal fluid studies, brain images and brain biopsies. Six patients exhibited slowly progressing neurologic symptoms characterized by the impairment of cognitive function, abulia, ataxic gait, and/or akinetic mutism. None of the patients had any specific causes or etiologic factors for leukoencephalopathy. Brain MRI in all patients showed diffuse periventricular white matter changes in the T2-weighted MR image. Brain biopsy in Patient 1 showed fragmented axonal fiber and minimally deprived myelination with many scattered macrophages. Five patients who treated with steroids at the onset of neurological symptoms showed clinical improvement, regardless of their age, sex, the pathology and stage of breast cancer, or the total dosage of chemotherapeutic agents. We conclude that leukoencephalopathy in these cases could be attributable to 5-FU neurotoxicity and suggest that the administration of steroids might be the treatment of choice.

Effects of collagen IV and laminin on the reconstruction of human oral mucosa

To investigate the effects of basement membrane proteins on the reconstruction of mucosa equivalent, oral mucosa substitute were cultured on (1) type I collagen gels, (2) type IV collagen-coated type I collagen gels, (3) laminin-coated type I collagen gels, and (4) type I collagen gels containing both type IV collagen and laminin. H/E and PAS staining showed that the characteristics of the oral mucosa were preserved under all the experimental conditions. However, the basal keratinocytes appeared cuboidal when the type I collagen gels were coated with type IV collagen plus laminin. The expression of the differentiation markers was similar, but weak staining of filaggrin, K13, and involucrin was observed with the type IV collagen plus laminin coating. Furthermore, electron microscopy revealed that the size of the basal keratinocytes was relatively small and uniform when both type IV collagen and laminin were used. These findings suggested that these two major basement membrane proteins are important in the process of differentiation in mucosal keratinocytes.

Normal and acutely torn posterior cruciate ligament of the knee at US evaluation: preliminary experience

PURPOSE

To determine the ultrasonographic (US) findings of normal and acutely torn posterior cruciate ligament (PCL) of the knee and evaluate the usefulness of US in the injured PCL.

MATERIALS AND METHODS

US images were obtained in 30 knees in 15 asymptomatic volunteers as a control group and in 35 patients clinically suspected of having an acute PCL injury. Only the distal half of the PCL was evaluated. Of the 35 patients, 28 had their PCL status confirmed: 13 had a normal PCL at magnetic resonance (MR) imaging plus clinical examination, and 15 had a torn PCL at either MR imaging and surgery or MR imaging and clinical follow-up.

RESULTS

Normal PCLs were homogeneously hypoechoic, with a well-defined posterior border. Torn PCLs were heterogeneously hypoechoic (12 [80%] of 15 patients), with an indistinct posterior margin (11 [73%] of 15 patients). Torn PCLs were significantly thicker (range, 12.0-20.0 mm; mean, 15.6 mm +/- 2.5 [SD]; P <.01), as compared with normal PCLs in 13 patients (range, 3.8-5.8 mm; mean, 4.6 mm +/- 1.0; P <.01) and in the volunteers (range, 3.7-6.2 mm; mean, 4.5 mm +/- 1.2; P <.01).

CONCLUSION

An acutely torn PCL thickens (>10 mm), loses its sharply defined posterior border, and has a heterogeneously hypoechoic appearance. US may be useful as a screening examination for patients suspected of having PCL injury and for deciding whether to perform more expensive MR imaging or surgical intervention.

Epstein-Barr virus-associated peripheral T-cell lymphoma in adults with hydroa vacciniforme-like lesions

We describe two Korean adult patients who had necrotizing papulovesicles mainly on their faces. Skin biopsy specimens showed perivascular and periadnexal infiltrate of atypical lymphoid cells with vasculitis in the dermis and subcutaneous tissue. In situ hybridization demonstrated a latent infection of Epstein-Barr virus in the majority of lymphoid cells in the dermis. These patients were diagnosed as having T-cell lymphoma. Interestingly, large granular lymphocytosis was found in the peripheral blood of Case 2.