Showing papers in "Yonsei Medical Journal in 1994"

Paraffinoma of the penis

Abstract: Augmentation of the body contour by localized injection of hard and soft paraffin rose to a zenith of popularity in the early 1900s, whereafter the severe destructive consequences of such injections became widely recognized. However in Korea, these injections are still performed much by nonmedical person. Paraffin or other mineral oil injection into body is no more a useful method to change body contour. We reviewed 26 cases of sclerosing lipogranuloma of penis with complications in recent 13 years after mean 18.5 months from previous injection of paraffin or vaseline. We conclude that the public should be informed of detrimental effects of paraffin injections and that the best treatment of penile paraffinoma is complete excision and appropriate penoplasty.

Acute myocardial infarction in the young adults.

Abstract: A review was done on 631 patients with acute myocardial infarction who underwent coronary angiography within 30 days after onset of myocardial infarction at Yonsei University Severance Hospital from January, 1985, to August, 1993. The incidence of acute myocardial infarction in patients under 40 years of age was 10.3% (65/631). Acute myocardial infarction below the fourth decades was the predominant disease of men. Risk factor analysis revealed a history of cigarette smoking and hypercholesterolemia were more frequently found in the young patients, but a history of hypertension and diabetes were more frequently found in the elderly patients. Angiographically, the incidence of one vessel disease and normal or minimal lesion coronary anatomy were more frequent in the young patients and incidence of multi-vessel disease were more frequent in the elderly patients. Of the 65 patients under 40 with acute myocardial infarction, the patients with multi-vessel disease tended to have a history of diabetes mellitus in comparison with those with normal coronary anatomy or one vessel disease.

The basal electrical skin resistance of acupuncture points in normal subjects.

Abstract: The inhibitory component of the skin against given electrical current, also called as the electrical skin resistance, is subject to change in response to many factors, especially pain. In order to find out more definite relationship between pain and skin resistance, one should make measurement in the state devoid of any external disturbing stimuli to get the "basal skin resistance (BSR)", which is known to be different from point to point on body surface. Also, the "active points" have more consistent BSR characters than other points and most of them share same locations with "acupuncture points" which is easy to localize accurately and repeatedly in normal subject. Therefore, the comparison of BSR of certain acupuncture points of normal subject and pain-suffering subjects is expected to be able to figure out any pain-induced BSR changes. Our measurement at 16 acupuncture points (asymmetrical 8 pairs) of 10 normal subjects showed inconsistently asymmetrical distribution of the BSR values with significant order among themselves including left SP (spleen)-6 at their lowest position, but neither the measuring system itself nor any of the 16 points was statistically reliable enough for diagnostic purposes. So the measuring device needs to be improved with after evolution, and more acupuncture points need to be explored to complete our pain-related BSR map. In addition, the meaning of the above BSR distribution pattern is waiting to be explained through such efforts.

Fatty acids directly increase the activity of Ca(2+)-activated K+ channels in rabbit coronary smooth muscle cells.

Abstract: The large conductance Ca2+ activated K+ channel (BK channel) has been considered to play an important role in the excitability and contractility of vascular smooth muscle cells Activation of the BK channel causes the hyperpolarization and relaxation of vascular smooth muscle cells It has been reported that fatty acids can affect the BK channel activity and its concentration is increased significantly during myocardial ischemia These reports suggest that fatty acids may contribute to the ischemic coronary vasodilation by increasing the BK channel activity However, the underlying mechanism of fatty acid-induced activation of the BK channel is still uncertain In the present study, we measured the effect of fatty acids on the BK channel activity in rabbit coronary smooth muscle cells by using patch clamp method and also examined its underlying mechanism Arachidonic acid (AA) dissolved in DMSO activated the BK channel in a dose-dependent manner (from 05 to 10 microM), and DMSO (01%) alone had no effect on the activity of the BK channel Arachidonic acid activated BK channels in both cell-attached and inside-out patches, but the onset and recovery of this effect were slower in the cell-attached patch configuration The BK channel activity was also increased by other fatty acids, including myristic acid, linoleic acid, palmitoleic acid and palmitic acid Long chain fatty acids were more effective than short chain fatty acids (myristic acid), and there was no statistical difference between the effect of saturated (palmitic acid) and unsaturated fatty acids (palmitoleic acid) on the BK channel activity The concentration of Ca2+ and Mg2+ in the bathing solution had no appreciable effects on the AA-induced increase of BK channel activity From the above results, it may be concluded that fatty acids directly increase the BK channel activity and may contribute to the ischemic coronary vasodilatation in rabbit coronary smooth muscle cells

Immunohistochemical studies from vitiligo--comparison between active and inactive lesions.

Abstract: Vitiligo is an acquired, progressive depigmenting disorder of unknown etiology. In this study, to clarify pathogenesis of vitiligo, the marginal skin of actively spreading and stable vitiligo was examined using ICAM-1, HLA-DR, CD4 and CD8 monoclonal antibodies. In immunohistochemical study, ICAM-1 was expressed in four of five epidermis in active lesions, but not in stable lesion. Dermal ICAM-1 was also expressed in all active and stable lesions. HLA-DR was also expressed in all active epidermis in active lesions, but two of five epidermis in stable lesion. Dermal HLA-DR was also expressed in all active and stable lesion. CD4 lymphocytes were expressed more strongly in active lesion, but CD8 lymphocytes were not different in both lesions. There was no significant difference of degree of positivity with CD4 and CD8 in normal control specimens. In conclusion, we think that ICAM-1 and HLA-DR expression, cytokines released from keratinocytes, melanocytes or lymphocytes and infiltration of activated T-lymphocytes play an important role in disease activity.

Mid-sagittal canal diameter and vertebral body/canal ratio of the cervical spine in Koreans.

Abstract: In order to ascertain the normal values of the mid-sagittal canal diameter and the canal/body ratio of the cervical spine in Korean adults, ninety sets of cervical vertebral columns were examined. The average mid-sagittal canal diameters from C3 through C7 in the normal Korean are 13.2 +/- 1.3 millimeters in male and 13.1 +/- 2.6 millimeters in female. The normal average canal/body ratio of the cervical spine is 0.93 +/- 0.10 in male and 1.02 +/- 0.09 in female. The mid-sagittal canal diameter is largest in the White population and smallest in Asian, but there is no racial differences in the canal/body ratio, and the lower limit of normal canal/body ratio is 0.8 in Korean. The authors conclude that measurement of the canal/body ratio is more reliable than direct measuring of the mid-sagittal diameter of the cervical spinal canal in the diagnosis of cervical spinal stenosis or predicting the prognosis of cervical spinal cord injury.

Detection of Treponema pallidum by polymerase chain reaction in the cerebrospinal fluid of syphilis patients

Abstract: To find out if polymerase chain reaction could be used as a diagnostic tool for detecting neurosyphilis, we have applied the PCR for the detection of Treponema pallidum DNA in the cerebrospinal fluid (CSF) of syphilis patients. The results of the PCR of the CSF in 26 patients with at various stages of illness were compared with the results of other conventional tests used in the WHO criteria. T. pallidum was detected in the CSF of patients at all stages of syphilis, which indicates that they invade the central nervous system from the early stages of infection. However, the presence of T. pallidum in the CSF was not correlated with the results of other tests used in the WHO criteria, and its significance in the diagnosis of neurosyphilis should further be evaluated.

Comparison of sympathetic skin response and digital infrared thermographic imaging in peripheral neuropathy.

Abstract: It is well known that the SSR (sympathetic skin response) is to evaluate the function of sudomotor activity and Digital infrared thermal imaging (DITI) is to evaluate the function of vasomotor activity of the sympathetic nerve. To assess the sympathetic nerve impairment in the patients with peripheral neuropathy, the SSRs and DITIs were tested in 35 cases. Twenty-four (68.6%) patients were abnormal on SSR test and twenty-nine (82.9%) patients were abnormal on DITI test. In the relationship between DITI and SSR, 19 (54.3%) cases were abnormal and 1 case was normal finding in both of these two tests. And the remaining 25 (42.9%) patients were abnormal on only either one of both tests. Frequency of abnormal SSR and DITI findings were correlated with severity of axonal involvement in peripheral nerve lesion. The results of this study revealed DITI to be more sensitive test in assessing sympathetic dysfunction in peripheral neuropathy than the SSR. However DITI has very limited values in the patients with symmetrically involved peripheral neuropathy because thermal asymmetry is considered as abnormal on DITI. Therefore, in assessing the function of sympathetic nerve in peripheral neuropathy, combined tests of SSR and DITI are useful.

Expression and localization of human papillomavirus type 16 E6 and E7 open reading frame proteins in human epidermal keratinocyte.

Abstract: Over 60 different types of human papillomavirus (HPV) have been identified, and they are classified into high and low risk groups based on the risk for malignant progression of HPV associated lesions. HPVs belonging to a high risk group have been shown to express two major transforming proteins, E6 and E7. With respect to the transforming activity of these proteins, many investigators have reported the location of these proteins in the cell, but their results are still controversial. In the present study, HPV type 16 E6 or E7 open reading frame (ORF) proteins were expressed and localized in human epidermal keratinocytes (RHEK-1) using the vaccinia virus as an expression vector. Immunofluorescence detection using monoclonal antibodies against E6 or E7 ORF proteins revealed that E6 or E7 proteins of HPV type 16 were located in the cytoplasm of RHEK-1 cells. These results suggest that E6 and E7 proteins bind to the tumor suppressor counterparts, thereby preventing transport of these proteins into the nucleus. These antioncogene products that fail to be rapidly transported out of the cytosol may be degraded by certain proteases such as the ubiquitin dependent system. In this way, the precise function of antioncogene products in the regulation of cell growth could be destroyed, and abnormal cell growth could occur.

Serodiagnosis of human sparganosis by a monoclonal antibody-based competition ELISA.

Abstract: Competition ELISA test using sparganum specific monoclonal antibodies (Mab) was investigated to improve the diagnostic specificity of sparganosis. By cell fusion, one hybridoma clone secreting anti-sparganum specific Mab was selected (Sp-20), which reacted on bands of 32 kDa and 38 kDa. Sp-20 reacted on calcium corpuscles on IFA. By micro-ELISA, 16 of 17 sparganosis cases (95%) were found positive, but 1 of 18 clonorchiasis cases (5%), 4 of 16 cysticercosis cases (25%) and 2 of 16 normal controls (11%) showed false positive reactions. On the other hand, by competition ELISA using a sparganum specific Mab (Sp-20), 16 out of 17 (95%) of sparganosis cases were found positive, but 2 of 18 clonorchiasis cases (10%), 2 of 16 cysticercosis cases (12%), 3 of 16 paragonimiasis cases (18%) and 1 of 16 normal controls (6%) showed false positive reactions.

Ten years of experience with various penile prosthesis in Korean

Abstract: Currently there are more than 10 types of penile prosthesis available, ranging from the very simple to the very sophisticated. We review our experiences with various penile prosthesis, with particular regard to the complication rate. From Dec. 1983 to Jul. 1993, we implanted 295 penile prosthesis of eight different types. The average age of patients was 44 years. Every patient was evaluated with various multidisplinary diagnostic approaches. The etiologies of impotence were vasculogenic 29%, diabetogenic 22%, spinal cord injury 16%, pelvic bone injury 11%, etc. The types of implanted prosthesis were AMS malleable 143, Jonas 42, Dynaflex 36, Hydroflex 8, Uni-Flate 1000 2, AMS 700 CXM 58, Ultrex 3, Mentor alpha-1 3 and the mean follow-up period was 34 months. The diameters of implanted prosthesis were from 9.5 mm to 13 mm, mostly 9.5 mm (52.9%). The length of implanted prosthesis were from 10 cm to 20 cm, mostly 16 approximately 18 cm (68.8%). Cases with uneven diameters or lengths were 20 (6.8%). The int aoperative complications were 1 corporeal rupture and 1 bladder rupture, and the postoperative complications were 2 prosthesis infections, 2 mechanical failures, and 1 prosthesis infection with mechanical failure. In those 4 patients reimplantations were successful. More than 99% (290/291) patients still have functioning prosthesis. Every prosthesis has their advantages and disadvantages. Factors to be analysed in the selection of proper prosthesis should include patients economic status, education, personality, social activity, hand dexterity, and penile size.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of depression and somatic symptoms among Korean elderly immigrants

Abstract: Forty-one Korean immigrants in Washington, D.C. (of the United States) metropolitan area over age 60 were interviewed using the Diagnostic Interview Schedule (Korean version) with additional questions about culture-specific somatic symptoms identified in previous research with Korean populations. The lifetime and current prevalence were 29.27 percent and 14.63 percent, respectively, for major depression; 9.76 percent and 2.44 percent for generalized anxiety disorder; and 9.76 percent and 7.32 percent for somatization disorder. The lifetime and current rates of co-occurrence of major depression and somatization disorder were 25 percent and 33.33 percent. Subjects who met criteria for depression were more likely to experience culture-specific Korean somatic symptoms than subjects who did not meet those criteria.

Combined treatment of radiotherapy and hyperthermia for unresectable hepatocellular carcinoma

Abstract: Eighty-four patients with unresectable primary hepatocellular carcinoma due either to locally advanced lesion or to association with liver cirrhosis were treated with combined radiotherapy and hyperthermia from April 1988 to January 1991. Purpose of this study was to assess thermometry, response rate, toxicity, and survival in those patients. External radiotherapy was given with a total of 30.6 Gy/3.5 wks. Hyperthermia was given twice a week with a total of 6 treatment sessions using an 8 MHz radiofrequency capacitive type heating machine. Each hyperthermia session was started within 30 min following radiotherapy and continued for 30-60 min. Thermal data were analysed with maximum, minimum, and average temperatures of the tumors. Thermal mapping was also done. In thermometry results, maximum, minimum, and average temperatures of the tumors were 41.9 +/- 1.3 degrees C, 39.9 +/- 1.0 degrees C, and 40.8 +/- 0.9 degrees C, respectively. The fraction over 40 degrees C was 73 +/- 32% with a wide variation from 15% to 100%. Among 67 assessable patients, 27 patients showed tumor regression of more than 50% of the original tumor volume (40.3% response rate). Symptomatic improvement was observed in 78.6% of the patients. Acute toxicities during the treatment were mostly acceptable local pain (51.2%) and local fat necrosis (13.1%). The actuarial 1-year, 2-year, and 3-year survival rates were 44.8%, 19.7%, and 15.6%, respectively. Median survival was 6 months. In view of acceptable toxicities and the current rate of survival, further evaluation of combined treatment of radiotherapy and hyperthermia for unresectable hepatocellular carcinoma is warranted.

Transrectal ultrasonography in preoperative staging of rectal cancer

Abstract: A precise knowledge of the depth of invasion of tumor is essential for the planning of treatment of rectal cancer. Transrectal ultrasonography is a new diagnostic modality that has become useful in determining the depth of invasion preoperatively and the presence or absence of metastatic lymph nodes. Transrectal ultrasonography was used in preoperative staging of 36 patients with rectal cancer. Thirty three patients had a radical resection (17 low anterior resection, 15 abdominoperineal resection and 1 pelvic exenteration), one patient had a local excision. Two among these thirty four patients had preoperative radiotherapy. Preoperative transrectal ultrasonographic staging was compared with pathologic findings. In staging depth of invasion, the overall accuracy was 88.8 percent, overstaged in 5.8 percent, understaged in 5.8 percent. Transrectal ultrasonography is the more accurate method than CT in staging of depth of tumor invasion (61.8% vs 88.8%). In staging of lymph nodes, the overall accuracy of transrectal ultrasonography was 85.3 percent, sensitivity was 71.7 percent and specificity was 88.8 percent. Transrectal ultrasonography is a safe, inexpensive and accurate staging method in the assessment of both depth of invasion and nodal status.

Antimicrobial susceptibility of Campylobacter fetus subsp. fetus isolated from blood and synovial fluid.

Abstract: Campylobacter fetus subsp. fetus is a rare human pathogen, but can cause serious extraintestinal infections. Effective antimicrobial agent is required for the therapy, but we have very limited knowledge on the susceptibility of the organism. In this study, the susceptibility of 25 isolates of the organism to 14 antimicrobial agents was tested by an agar dilution method. Antimicrobial agents with low MIC ranges, in micrograms/ml, were: meropenem < or = 0.25, dirithromycin < or = 0.5, gentamicin < or = 1, amikacin, ofloxacin, tetracycline and erythromycin < or = 2. The MIC range of cefepime was 0.5-8 micrograms/ml, but those of other beta-lactams were relatively high. All of the isolates were interpreted to be susceptible to cefepime, meropenem, amikacin, gentamicin, ofloxacin, tetracycline and dirithromycin. A significant proportion of the isolates were either intermediate or resistant to ampicillin, cephalothin, cefotaxime, aztreonam, loracarbef and erythromycin. In conclusion, the organism remains susceptible to aminoglycosides and tetracycline. Greater in vitro activity of meropenem, ofloxacin and dirithromycin require clinical evaluation.

Measurement of IgE and IgG subclass antibodies to whole body antigen and two major allergens (Der fI & Der fII) of Dermatophagoides farinae in normal subjects and asthmatics.

Abstract: House dust mites have been known as the most important allergen in respiratory allergic diseases. Among several mite allergens, group I and group II antigens were recognized as major allergens. We measured specific IgE and IgG subclass antibodies against whole body antigen (WBA) and two major allergens of Dermatophagoides farinae (Der fI and Der fII) in sera from 66 adults with asthma (asthma group) and 34 normal subjects (healthy group) by ELISA. The mean O.D. values of WBA-specific IgE and IgG subclass antibodies in 100 studied sera were significantly higher than those of the two major allergens (p < 0.001) and the level of Der fII- IgG1, IgG4 and IgE were higher than those of Der fI but IgG2 of Der fI was higher than that of Der fII (p < 0.001). The level of IgG4 of WBA were significantly higher in the atopic group than in the nonatopic group (1.280 +/- 0.634 v.s. 0.8290 +/- 0.388, p < 0.001), but the WBA- IgG1, IgG2, IgG3 were not different between the two groups. Among IgG subclass antibodies of Der fI, IgG2 was significantly higher in the nonatopic group than in the atopic group (1.7770 +/- 0.255 v.s. 1.636 +/- 0.390, p < 0.05) but there were no differences in IgG1, IgG3, and IgG4. Among IgG subclass antibodies of Der fII, IgG2 (1.534 +/- 0.380 v.s. 1.3010 +/- .431, p < 0.05) and IgG4 (1.09650 +/- .567 v.s. 0.708 +/- 0.146, p < 0.001) were significantly higher in the atopic group than in the nonatopic group. IgE antibodies to WBA, Der fI and Der fII were significantly higher in the atopic group (p < 0.001). There were significant correlationships between the levels of IgE and IgG4 of WBA (r = 0.60), Der fI (r = 0.33) and Der fII (r = 0.72). Even though there were no differences in the levels of allergen specific IgE and IgG subclass antibodies between nonatopic healthy and nonatopic asthmatic groups, the number of sera with prominent level of IgG2 of WBA were more common in the nonatopic asthmatic group (69% in nonatopic asthma group v.s. 28% in nonatopic healthy group, X2-test, p < 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)

Chest wall implantation of carcinoma after fine needle aspiration biopsy

Abstract: Implantation of malignant cells along the needle aspiration tract in patients with lung cancer is a rare but potential complication following percutaneous fine needle aspiration biopsy. Dissemination of cancer cells by aspiration biopsy can change resectable, potentially curable lung cancer to unresectable cancer. We report a 55 year male patient who underwent completion pneumonectomy due to squamous cell carcinoma and one cycle of chemotherapy. He developed outgrowing chest wall tumor at the site of needle aspiration biopsy performed prior to completion pneumonectomy and was pathologically diagnosed as metastatic squamous cell carcinoma. The lesion was successfully treated by radical full-thickness resection of the chest wall and reconstruction with latissimus dorsi musculocutaneous island flap.

Effects of dimethyl methylphosphonate (DMMP) and trimethylphosphate (TMP) on spermatogenesis of rat testis.

Abstract: Both dimethyl methylphosphonate (DMMP) and trimethylphosphate (TMP) are organophosphorous compounds that can evoke sterility in male rodents. The following studies examined the pathology of reproductive organ, especially on the testis, by light microscopy after treatment with both agents. Adult male rats were treated per oral with DMMP, 1,750 mg/Kg, for up to 12 weeks and per oral with TMP, 400 mg/Kg for up to 5 weeks. After 5 weeks of treatment with DMMP there were occasional multinucleated giant cells composed of late spermatids in stages X, XI, XII as well as cytoplasmic vacuolation of Sertoli cell. Anachronistic spermiations were seldom, if ever, seen throughout the experiment. After 7 weeks of DMMP those were markedly diminished. The overall changes after treatment with TMP are somewhat similar to those treated with DMMP. The major changes were composed of aggregate of multinucleated giant cells and maturation arrest at spermatid level, which appear immediately after administration of TMP. The peak frequency in the emergence of multinucleated giant cells in treatment with TMP was noted just a week after treatment, but afterwards declined. Maturation arrest was prominent after 3 weeks in the cases treated with TMP.

Adaptive response to ionizing radiation induced by low dose of gamma ray in human hepatoma cell lines.

Abstract: When cells are exposed to a low dose of a mutagenic or clastogenic agent, they often become less sensitive to the effects of a higher dose administered subsequently. Such adaptive responses were first described in Escherichia coli. Studies on mammalian cells have been limited to human lymphocytes exposed to low doses of an alkylating agent. In this study, the adaptive response to 1 cGy of gamma rays was investigated in human tumor cells using two human hepatoma cell lines, Hep G2 and Hep 3B. Experiments were carried out by delivering 1 cGy followed by 50 cGy of gamma radiation and chromatid breaks were scored as an endpoint. The results of this study indicate that prior exposure to 1 cGy of gamma rays reduces the number of chromatid breaks induced by subsequent higher doses (50 cGy). The time necessary for the expression of the adaptive response was determined by varying the time interval between the two doses from 1 hour to 72 hours. In G2 chromatids, the adaptive response was observed both at short time intervals, as early as 1 hour, and at long time intervals. In S chromatids, however, the adaptive response was shown only at long time intervals. When 3-aminobenzamide, an inhibitor of poly (ADP-ribose) polymerase, was added after 50 cGy, adaptive responses were abolished in all the experimental groups. Therefore, it is suggested that the adaptive response can be observed in human hepatoma cell lines, which is first documented through this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Spigelian hernia in children--report of two cases and review of the literature.

Abstract: Two children with spigelian hernias are presented in this report. The etiopathogenesis and surgical anatomy of these rare hernias were discussed. Our cases are the fourth and fifth cases of spigelian hernia (SH) in patients under 2 years of age. Surgical intervention is indicated in all cases of SH because of the danger of strangulation of the bowel.

Obstructive jaundice due to compression of the common hepatic duct by right hepatic artery--a case associated with the absence of the lateral segment of the left hepatic lobe.

Abstract: Various benign and malignant conditions can cause biliary obstruction. We present a rare case of obstructive jaundice due to the compression of the common hepatic duct by the anteriorly overriding right hepatic artery. This case was also associated with the absence of the lateral segment of the left hepatic lobe. The patient was a 39 year-old housewife with a 4-day history of jaundice and occasional febrile sensation. An abdominal computed tomography showed absence of the lateral segment of the left hepatic lobe and a percutaneous transhepatic cholangiography showed a band-like filling defect of 2 mm width at the level of the upper common hepatic duct. The anteriorly overriding right hepatic artery compressing the common hepatic duct and the absence of the lateral segment of the left hepatic lobe were confirmed by operation.

Volvulus of the splenic flexure of the colon.

Abstract: The definition of volvulus is an axial twist of a portion of the gastrointestinal tract along its mesentery. The involved bowel is obstructed partially or completely with a variable degree of arterial and venous occlusion. The colon is the most common site for volvulus. The splenic flexure is the least common site of colonic volvulus. We experienced a case of the volvulus of the splenic flexure. It will be the 30th case of the volvulus involving the splenic flexure in the English literature, to our knowledge. A 30-year-old woman was admitted due to abdominal pain and distention with vomiting. An emergency barium study revealed characteristic "bird beak" sign. Surgery was performed resecting the involved colon of splenic flexure. The result was excellent.

Malignant fibrous histiocytoma in chordoma--immunohistochemical evidence of transformation from chordoma to malignant fibrous histiocytoma.

Abstract: Sarcomatous transformation in chordoma (dedifferentiated chordoma) is a very rare condition and has been emphasized as a distinct entity because of its more aggressive clinical course. Here we describe a case of dedifferentiated chordoma (chordoma associated with malignant fibrous histiocytoma) arising from the sacrococcygeal region of a 55-year-old woman. The results of immunohistochemical stain in the chordoma area were strong positive for cytokeratin, epithelial membrane antigen and S-100 protein. The spindle and giant cells in the transitional areas of chordoma and malignant fibrous histiocytoma were positive for cytokeratin and epithelial membrane antigen in addition to vimentin and alpha-1-antichymotrypsin. The spindle and giant cells in the central area of malignant fibrous histiocytoma were negative for cytokeratin and epithelial membrane antigen, but positive for vimentin and alpha-1-antichymotrypsin. This supports the pathogenesis of sarcomatous transformation from chordoma.

Induction of hepatic ATP-citrate lyase by insulin in diabetic rat--effects of insulin on the contents of enzyme and its mRNA in cytosol, and the transcriptional activity in nuclei

Abstract: The effects of insulin on ATP-citrate lyase, its mRNA in cytosol, and the transcriptional activity in nuclei of diabetic rat liver were studied. Experimental diabetes was induced by an intraperitoneal injection of streptozotocin, and livers were removed from rats at 0, 1, 3, 6, 16, and 72 hours after the administration of insulin. ATP-citrate lyase began to increase at 16 hours, and continuously increased until 72 hours. The amount of mRNA encoding ATP-citrate lyase increased abruptly at 16 hours, then decreased to near basal level in 72 hours. No change in the transcription rate was observed until 3 hours after insulin administration. However, the activity increased 4-fold at 6 hours and 7-fold at 16 hours, 16-fold at 6 hours and 28-fold at 16 hours when pGACL1 and pGACL2 were used as probes, respectively, preceding the increase in the amounts of mRNA and the enzyme. It is suggested that the increase in the amount of ATP-citrate lyase by insulin is primarily due to the increase in the transcriptional activity of the gene in nuclei, which results in the subsequent increase in the amount of mRNA for the biosynthesis of ATP-citrate lyase in cytosol.

Solitary rectal ulcer syndrome.

Abstract: We report three cases of solitary rectal ulcer syndrome (SRUS). The diagnosis was established according to histopathologic criteria. But, the initial clinical diagnosis was carcinoma, non-specific ulcer and localized proctitis respectively. SRUS is considered as one of functional disorder in pelvic floor which might go underdiagnosed due to unfamiliar concept in Korea. So we should consider SRUS to be one of the differential diagnosis in cases of complaining anorectal symptoms.

Chondrocyte allograft transplantation for damaged growth plate reconstruction.

Abstract: The growth plate is responsible for longitudinal bone growth. The problem of repair of damaged growth plate in children has never been adequately solved. The purpose of this study is to investigate the ability of the cultured chondrocyte for the prevention of bony bridge and repairment of damaged growth plate. Chondrocytes were obtained from the new born canine epiphyseal plate and was cultured in high density. Fourteen days later they formed micromass easily removable from the culture flask. Twenty dogs were divided into two groups; in group I, the medial proximal tibial growth plate was destroyed and then cultured chondrocytes were transplanted into the defect, and in group II, the medial proximal tibial growth plate was left in destroyed state. Each left leg was remained as a control. The growth pattern was observed radiographically and histologically until 16 weeks after graft. 4 weeks after the operation, the angular deformity had been observed, and 31 degrees of angulation was noted at the 16th week in group II, while there was less than 8 degrees of angulation and nearly normal growth in most of dogs of group I (8 of 10 dogs). The other 2 dogs had shown 20 degrees angulation. In group II, there was definite bony bridge on the medical proximal growth plate. In group I, initially, the cultured chondrocyte remained as a amorphous cartilagenous mass, but as time progressed, amorphous cartilagenous mass had formed cartilagenous matrix which was proved by Safranin-O staining. Although this study showed the role of cultured chondrocyte as a method of preventation of bony bridge formation and possibility to repair of growth plate, further studies should be done to prove the reconstruction of the growth plate.

Mechanism of decrease in heart rate by peripheral dopaminergic D2-receptors.

Abstract: We performed this study in order to verify the heart rate decrease caused by the D2-receptor on cardiac sympathetic nerve endings and its relation to the concentration of norepinephrine in synaptic clefts. Sprague-Dawley rats were pithed and the heart rate was increased either by electrical stimulation of the cardiac accelerator nerve or by intravenous infusion of norepinephrine, tyramine, or isoproterenol. Increased heart rate by electrical stimulation of cardiac accelerator nerve was dose-dependently lowered by lisuride and its effect was blocked by pretreatment with sulpiride but not with yohimbine and SCH 23390. Also, the heart rate was decreased in a dose-dependent manner by clonidine and this effect was blocked by pretreatment with yohimbine, but not with sulpiride. For increased heart rate by infusion of norepinephrine, tyramine, or isoproterenol, the heart rate lowering effect of lisuride was more marked in the norepinephrine-and tyramine-infusion groups, in which the intrasynaptic concentration of norepinephrine was elevated, compared to the isoproterenol-infusion group, in which intrasynaptic concentration of norepinephrine was not elevated. In conclusion, there is a D2-receptor on the cardiac sympathetic nerve endings which decreases the heart rate and is different from the presynaptic alpha 2-receptor. Also, the heart rate lowering effect via stimulation of the D2-receptor by lisuride was more marked with increased concentration of norepinephrine in the synaptic cleft.

Hematologic changes in acute carbon monoxide intoxication

Abstract: This study was performed to investigate the hematologic changes and its pathogenesis in acute carbon monoxide (CO) intoxication. Serial complete blood counts (CBC) were obtained in 17 patients with acute CO intoxication five times in two weeks. Peripheral blood smear, bone marrow aspiration and biopsy were obtained in 7 patients within the first week. We analyzed the results of serial CBC's. Levels of hemoglobin and hematocrit rose only initially, probably due to dehydration and hemoconcentration rather than hypoxia. Leukocytosis, mainly neutrophilic, observed during the first few days seemed to be a physiological phenomena due to a stressful situation, such as hypoxia. Levels of platelet increased steadily after a initial decrease. We found no specific findings in bone marrow.

In vitro sound spectral analysis of prosthetic heart valves by mock circulatory system

Abstract: A comparative study was made of the sounds produced by normal prosthetic valves (St. Jude Medical, Bjork-Shiley, polymer) with those produced by the same valves but having simulated thrombosis at the stent, hinge, or strut. Comparisons of the closing sound were made for the power frequency spectra associated with individual valves. We used periodogram approach to obtain the spectral characteristics of the valve prostheses. The closing sound of the abnormal mechanical valves displayed lower apparent peak frequency. But the abnormal polymer valve produced higher apparent peak frequency. The results showed that frequency spectra gave information pertinent to the simulated malfunction. Sound spectral analysis is believed to be a simple and a good diagnostic tool for detection of prosthetic valve malfunction. Also it seemed to be superior to other methods such as phonocardiography and echocardiography.

Intra-carotid thrombolytic therapy in acute ischemic stroke of carotid arterial territory.

Abstract: Intra-carotid urokinase (UK) infusion in 20 patients with acute internal carotid artery (ICA) territorial ischemic stroke achieved immediate recanalization in 45% and the clinical outcome in patients with recanalization was superior to that of patients without recanalization. The procedure was most effective in patients with smaller arterial occlusions: 7 of 10 patients with MCA branch occlusions (M2 to M4) achieved recanalization compared to only 2 of 10 with distal ICA or M1 occlusions, which should be an important issue for the critical evaluation of the efficacy of thrombolytic therapy (TT). Hemorrhagic transformation was observed in 9 patients on CT scan; petechial hemorrhage in 5 and intraparenchymal hematoma formation in 4. Among 4 patients with hematoma formation, clinical deterioration was seen in 3 cases and the angiography at the immediate end of the UK infusion showed recanalization in only one patient. The average dose of UK in patients with parenchymal hematoma formation was higher than that of patients without hemorrhagic transformation (123.3 x 10(4) units vs 101 x 10(4) units). The administration of a large dose of UK, probably more than 100 x 10(4) units, and the absence of immediate recanalization seemed to increase the risk of parenchymal hematoma formation. Despite the effort of investigators, the in-hospital time delay for the TT was significant which was mainly related to the time consuming preparation for angiography especially during night. A more effective system for the earlier intervention of acute ischemic stroke needs to be developed.