OBJECTIVE: Lectins are cell-agglutinating and sugar specific proteins or glycoproteins of non-immune origin that precipitate glycoconjugates having saccharides of appropriate complementarity. Because of these properties, plant lectins have been used to help characterize the carbohydrate moieties of glycoproteins in the zona pellucida (ZP) of several mammalian species including pigs. Treatment of oocytes with various lectins blocks sperm binding to the ZP in various mammalian species. This study was undertaken to examine the distribution of sugar residues in the ZP of pig oocytes matured in vitro and the ability of spermatozoa to bind to ZP and in vitro penetration in oocytes treated with fluorescein isothiocyanate (FITC)-labelled lectins. MATERIALS AND METHODS: The lectins of Banderiaea simplicifolia (BS-II, bind to beta-D-Nacetylglucosamine), Canavalin ensiformis (Con A, bind to alpha-D-Mannose), Lens culinaris (LCA, bind to alpha-D-Mannose), Ricinus communis (RCA-I, bind to beta-D-Galactose) and Ulex europaeus (UEA-I, bind to alpha-L-Fucose) were examined for spermatozoa penetration, binding capacity to ZP and distribution of lectins. RESULTS: The penetration rates were significantry (p<0.05) higher in control oocytes (63%) than those treated with all lectins, but penetration rates (40~49%) were simililar in group treated with lectins. The incidence of monospermy was similar in oocytes untreated and UEA-I, but it was higher in oocytes treated with BS-II, Con A, RCA-I and LCA. The porcine oocytes cultured for 48 h in TC-199 medium were freed from cumulus cells and treated for 30 min with fluorescein isothiocyanate-labelled lectins. When examined under fluorescein illumination, higher (p<0.001) proportions of oocytes showed fluorescein of zona pellucida after treatment with Con A (93%), LCA (93%) and RCA-I (100%) than BS-II (37%) and UEA-I (50%). All of the oocytes treated with RCA-I exhibited strong fluorescein in the outer region of the zona pellucida while those treated with LCA exhibited strong fluorescein throughout the zona pellucida. BS-II bounded mainly to the outer region and UEA-I bounded mainly to the inner region of the zona pellucida, with either strong or weak fluorescein. At 120 min after insemination in vitro, fewer spermatozoa were bound to the zona pellucida of the oocytes treated with BS-II, Con-A and RCA-I. Of the lectins, Con A most inhibited sperm binding. CONCLUSIONS: These results suggest that beta-D-Galactose residues in the porcine zona pellucida may act as primary sperm receptors and inducers of the sperm acrosome reaction and these sugar residues may be involved in the block to polyspermy.
Acrosome Reaction ; Cumulus Cells ; Fluorescein ; Glycoconjugates ; Glycoproteins ; Herpes Zoster* ; Incidence ; Insemination ; Lectins* ; Lens Plant ; Lighting ; Oocytes ; Plant Lectins ; Ricinus ; Sperm-Ovum Interactions ; Spermatozoa ; Swine ; Ulex ; Zona Pellucida*

No abstract available.
Peutz-Jeghers Syndrome*

We studied the effects of botulinum A toxin in 101 patients with hemifacial spasm and 11 patients with blepharospasm in an open trial and double blind manner. All patients in the open trial and 6 patients in the double blind trial improved after the first injection of botulinum toxin. There was no improvement with placebo. The peak effect ranged from one to 6 days after injection and mean peak effect was 3.6 days in blepharospasm, and 4 days in hemifacial spasm. Of 144 treatments, 98.6% had excellent results, (below grade I). The duration of beneficial effect ranged 11 to 40 weeks (mean 16.5 weeks) in hemifacial spasm and 9 to 30 weeks (mean 14.2 weeks) in blepharospasm. Complications were encountered in 63.4% in hemifacial spasm and 72.7% in blepharospasm. The common side effects were dry eyes, mouth droop, ptosis and lid edema in order of frequency. These side effects were mild and resolved spontaneously in 1 to 3 weeks. Botulinum A toxin therapy is effective and convenient, and the treatment of choice for patients with hemifacial spasm and blepharospasm.
Adult ; Aged ; Blepharospasm/*drug therapy ; Botulinum Toxins/adverse effects/*therapeutic use ; Double-Blind Method ; *Facial Muscles ; Female ; Humans ; Male ; Middle Aged ; Spasm/*drug therapy

PURPOSE: The purpose of this study is to analyze the etiology of gynecomastia confirmed by breast operation among children under the age of 15 exhibiting clinical symptoms. METHODS: Twenty patients under the age of 15 were diagnosed as having gynecomastia in the past 10 years. The number of pathologically confirmed gynecomastia patients was 15. The causes or related diseases were examined. Various clinical manifestations and radiological findings related to gynecomastia were evaluated. RESULTS: Of 20 pediatric patients diagnosed as having gynecomastia, 8 cases were pubertal or idiopathic gynecomastia, but 12 cases (60%) had underlying causes. The 12 cases had an etiology, 6 cases were related to abnormal sexual differentiation, 4 cases were drug-induced, and 2 cases were obesity-related. Of the 4 drug-related cases, the past history of long-term medication of anti- tuberculous drug, INH, was present in 3 cases and thiazide in one case. In the group related to abnormal sexual differentiation, pseudohermaphroditism was found in 3 cases and Reifenstein SD, Maffucci SD, and Klinefelter SD was found in each case. CONCLUSION: Although it is known that most gynecomastia is either idiopathic or puberty-related, we were able to discover etiologic agents such as drugs, obesity, and abnormal sexual differentiation in 60% of the children under 15 of age years old. Therefore, in children with gynecomastia, the presence of any congenital diseases should be searched carefully, and the underlying cause of gynecomastia should be thoroughly searched for.
Breast ; Child* ; Disorders of Sex Development ; Gynecomastia* ; Humans ; Male ; Obesity ; Sex Differentiation

The metastasis of uterine leiomyosarcoma to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiomyosarcoma, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiomyosarcoma.
Carboplatin ; Deglutition ; Drug Therapy* ; Leiomyosarcoma* ; Lymphatic Diseases* ; Neck ; Neoplasm Metastasis ; Paclitaxel ; Radiotherapy* ; Spinal Canal ; Spinal Cord Compression ; Spine

Although anterior cervical plates are thought to be good tools, their clinical results have not been compared with those of anterior cervical fusion without a plating system in the domestic scientific literature. As there are some advantages as well as shortcomings in these two surgical methods, it is imperative to know which one might be better in terms of the postoperative complications and management. Therefore, the authors reviewed 80patients undergoing anterior cervical fusion during the period of January 1992 to May 1994. Top plate placement was made in 25 and simple fusion without a plating system was applied in 55. The average follow-up period was 9.6 months. In the patients undergoing simple cervical fusion, thirty-two patients(58%) needed rigid braces such as halo braces and Minerva casts for 3 months postoperatively. Thirteen patients(24%) showed graft complications including graft extrusion, whereas patients undergoing plate placement needed only semi-rigid Philadelphia braces for 4 to 8 weeks pos toperatively. Two patients(8%) showed graft setting and screw breakage without any indication of reoperation. However there appeared no difference in the immediate postoperative course of clinical symptoms and the fusion rate(95 vs 96%) at the final follow-up day between the simple fusion and the plate placement patients. The authors conclude that a plating system in anterior cervical fusion may be safe in spite of more extensive operations, and is more likely to offer postoperative stability in the cervical spine and early ambulation and rehabiliation without rigid braces.
Braces ; Early Ambulation ; Follow-Up Studies ; Humans ; Postoperative Complications ; Reoperation ; Spine ; Transplants

Although anterior cervical plates are thought to be good tools, their clinical results have not been compared with those of anterior cervical fusion without a plating system in the domestic scientific literature. As there are some advantages as well as shortcomings in these two surgical methods, it is imperative to know which one might be better in terms of the postoperative complications and management. Therefore, the authors reviewed 80patients undergoing anterior cervical fusion during the period of January 1992 to May 1994. Top plate placement was made in 25 and simple fusion without a plating system was applied in 55. The average follow-up period was 9.6 months. In the patients undergoing simple cervical fusion, thirty-two patients(58%) needed rigid braces such as halo braces and Minerva casts for 3 months postoperatively. Thirteen patients(24%) showed graft complications including graft extrusion, whereas patients undergoing plate placement needed only semi-rigid Philadelphia braces for 4 to 8 weeks pos toperatively. Two patients(8%) showed graft setting and screw breakage without any indication of reoperation. However there appeared no difference in the immediate postoperative course of clinical symptoms and the fusion rate(95 vs 96%) at the final follow-up day between the simple fusion and the plate placement patients. The authors conclude that a plating system in anterior cervical fusion may be safe in spite of more extensive operations, and is more likely to offer postoperative stability in the cervical spine and early ambulation and rehabiliation without rigid braces.
Braces ; Early Ambulation ; Follow-Up Studies ; Humans ; Postoperative Complications ; Reoperation ; Spine ; Transplants

BACKGROUND: It was known that conventional stress-redistribution imaging was not adequate for detection of severely ischemic but viable myocardium. Albeit the gold criteria of viable myocardium is the presence of metabolism which can be detected by PET, reinjection technique was reported to be able to identify most, if not all, of viable myocardium. Because reinjection imaging is performed immediately after redistribution imaging, an additional redistribution could be happened if we follow the patient longer. To prove the guess authors performed an additional delayed imaging 24 hours after reinjection of 201T1. METHODS: Subject patients were 20 ischemic heart disease patients who showed irreversible perfusion defect(s) on standard pharmacologic(dipyridamole) stress-redistribution images. Immediately after the redistribution images were obtained, 37 MBq thallium was injected at rest, and images were reacquired at 10 minutes and 24 hours after reinjection. Four sets of images(stress, redistribution, reinjection and delayed images) were then analyzed qualitatively and quantitatively. Left ventricle was arbitrarily divided into 9 segments(apex, proximal and distal portions of anterior, septal, inferior and lateral walls). RESULTS: These were 45 irreversible perfusion defects in 20 subject patients, of which 21(46.7%) showed improved thallium uptake after reinjection. Among these 21 segments 2 demonstrated further improvement of uptake on 24-hour delayed images, of the 24 regions determined to have persistent defects after reinjection. 10(41.7%) showed improved uptake on delayed images. CONCLUSIONS: In addition to reinjection imaging, 24-hour delayed imaging after reinjection was also helpful to identify severely ischemic but viable myocardium.
Dipyridamole* ; Heart Ventricles ; Humans ; Metabolism ; Myocardial Ischemia ; Myocardium* ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Fractures, Compression* ; Vertebroplasty*

Generally, esophageal cancer metaetasizes to lymph node, lung, liver but metastasis to another digestive organ is very rare. A 51 year old man who had experienced dysphagia for 1 month was diagnosed as an esophageal cancer. After combined radiation therapy and chematherapy(5-FU, cisplatinum), he still had dysphagia. After implanta tion of self-expandable metallic esophageal stent, he could swallow solid food. Recently, he experienced pharyngeal pain for 1 month. Endoscopy showed multiple nodules in right pyriform sinus. Biopsy specimen revealed squamous cell carcinoma. Because the distance between esophageal cancer and pharyngeal nodule is more than 10 cm and computed tomography of the neck shows normal esophageal wall no cervical lymphadenopathy, we concluded that this case was an esophageal cancer with metastasis to the pharynx. Hence, we reported a case of esophageal cancer with pharyngeal metastasis with a review of literatures.
Biopsy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms* ; Humans ; Liver ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neck ; Neoplasm Metastasis* ; Pharynx* ; Pyriform Sinus ; Stents