The diagnosis of soft tissue osteochondroma should be considered when a well-defined osseous mass is located in the soft tissues. The differential diagnosis includes myositis ossificans, tumoral calcinosis, synovial chondromatosis, and soft tissue osteosarcoma, true osteochondroma which arises from bone. One case of soft tissue osteochondroma in the knee, a lesion of uncertain pathogenesis is reported.
Calcinosis ; Chondromatosis, Synovial ; Diagnosis ; Diagnosis, Differential ; Knee ; Myositis Ossificans ; Osteochondroma* ; Osteosarcoma

No Abstract Available.
DNA* ; Interleukin-12* ; Mycobacterium tuberculosis* ; Mycobacterium*

BACKGROUND: The inhibitory effects of nitric oxide(NO) on platelet adhesion and vascular smooth muscle cell(VSMC) proliferation may have a possible role inhibiting development of neointima following balloon catheter induced injury. We tested the hypothesis that L-arginine, the precursor of NO, would attenuate neointima formation following balloon catheter induced injury via regulation of antagonistic balance between proliferation and apoptosis of VSMC. METHODS: Adult, male Sprague-Dawley rats(300 to 400g) were anesthetized with ketamine (100mg/kg intraperitoneally). The left common and external carotid artery were exposed. For endothelial denudation, 2mm angioplasty catheter was introduced through the left external carotid artery into the left common carotid artery. The catheter was inflated at I atm. and withdrawn three times. Animals were randomized to receive 2.25% L-arginine in their drinking water(n=14) or placebo(n=16) from 2 days prior to and 9 days following denudation. VSMC proliferation was quantified by immunohistochemical staining with an antibody to the proliferating cell nuclear antigen(PCNA). The cells undergoing apoptosis were identified by terminal nucleotidyl transferase-mediated nick end labeling(TUNEL) method and morphologic changes by computerized planimetry and transmission electron microscopy. RESULTS: 1) The neointimal area in injured arteries were significantly reduced in L-arginine supplemented animals compared with placebo group(p<0.05). 2) L-arginine administration significantly reduced the number of PCNA positive cells in neointima when compared with placebo at 9 days(p<0.05). 3) Positive TUNEL cells were not influenced by L-arginine supplementation. 4) On transmission electron microscopy, there were no cells showing characteristics of apoptosis in neointima. CONCLUSION: These results suggested that the inhibitory effect of L-arginine on neointima formation is due to reduced VSMC proliferation, but is not due to increased VSMC apoptosis at the early time period after initmal injur .
Adult ; Angioplasty ; Animals ; Apoptosis ; Arginine* ; Arteries ; Blood Platelets ; Carotid Artery, Common ; Carotid Artery, External ; Catheters ; Drinking ; Humans ; In Situ Nick-End Labeling ; Ketamine ; Male ; Microscopy, Electron, Transmission ; Muscle, Smooth, Vascular ; Neointima* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Vascular System Injuries*

In a study of intacranial metastases, 46 cases having satisfactory clinical, operative and histological proofswere analyzed by computerized tomography at Presbyterian Medical Center from May, 1982 to February, 1986. Theresults were as follows: 1. The male to female ratio of itracranial metastases were 67:33. The 5th decade group(34.8%) was the most prevalent age group, followed by the 6th decade(21.7%) and 7th decade(21.7%). 2. The numberof lesions was found to be: single-25 cases(54.3%); multiple-21 cases(45.7%). 3. The source of intracranialmetastases found to be: lung 15 cases(32.6%); unknown 12 cases(26.0%); chorioca 3 cases(6.5%); liver 3cases(6.5%); liver 3 cases(6.5%); stomach 2 cases(4.3%); parotid, breast, kidney, prostate, melanoma, rectal ca.rhabdomyosarcoma, nasal ca. lymphoma, testicular ca, cervix, each 1 case(2.2%). 4. The locations of theintracranial metastases were as follows: Cerebral hemisphere 37.7% in parietal region Cerebra hemisphere 15.9% inin frontal region Cerebral hemisphere 13.4% in occipital region Cerebra hemisphere 10.5% in temporal regionCerebellar hemisphere 3.2% Cerebellopontine angle 3.2% Intraventricular 4.8% Meninges 4.8% Skull vault 6.5% 5.Peritumor edema was found to be: Grade II-17 cases(37.0%): Grade III-14 cases(30.4%); Grade I-8 cases(17.4%);Grade 0–7 cases(15.2%) in that order. 6. The chief complaints of intracranial metastases on admission, were asfollows: Headache 30 cases(65.2%); Vomiting 11 casees(23.9%); deteriorated mental state 10 cases(21.6%);Hemiplegia 7 cases(15.2%); visual disturbance 6 cases(13.0%); hemiparesis 4 cases(8.7%); seizure 4 cases(8.7%);other symptoms were less frequent. 7. On pre-contrast scan, hyperdense lesions were present in 18 cases(39.1%);hypodense lesions in 15 cases(32.6%); mixed density in 8 cases(17.4%); isodenisty was present in 5 cases(10.9%).On post-contrast scan, ring enhancement was seen in 19 cases(41.3%); nodular enhancement in 17 cases(37%); mixedring-nodular enhancement in 8 cases(17.4%); only hypodense 2 cases(4.3%).
Breast ; Cerebellopontine Angle ; Cerebrum ; Cervix Uteri ; Edema ; Female ; Headache ; Humans ; Kidney ; Liver ; Lung ; Lymphoma ; Male ; Melanoma ; Meninges ; Neoplasm Metastasis ; Occipital Lobe ; Paresis ; Parietal Lobe ; Prostate ; Protestantism ; Seizures ; Skull ; Stomach ; Vomiting

This is the report of 98 cases in renal allograft, which were treated at Yeungnam University Hospital from January 1994 to July 1996 and compared the significance of changes of TNF alpha, IL-2R, IL-6 in blood and urine as an early diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF alpha, IL-2R, IL-6 in patients with renal allografts. Renal allografts patients were divided into four groups (control, acute rejection, acute tubular necrosis, systemic infection) according to their postoperative diagnostic methods. Blood and urine samples in four groups were obtained: control group (2 days before transplantation, at the day of transplantation and every other day after transplantation), acute rejection group (everyday sampling from 2 days before therapy to the end of therapy), acute tubular necrosis and systemic infection group (everyday sampling from the day of diagnosis to the end of therapy). In acute rejection group, there were significant elevation of cytokines; plasma TNF alpha (68.4%, p<0.01), IL-2R (73.6%, p<0.01), and IL-6 (89.5%, p<0.01), urinary TNF-alpha (42.1%, p<0.01), IL-2R (89.5%, p<0.01) and IL-6 (94.7%, p<0.01). In systemic infection group, all cytokines except urinary TNF-alpha were significantly elevated. The results suggested that plasma and urinary TNF-alpha, IL-2R, and IL-6 may play a complementary early diagnostic tool of acute rejection in renal allograft patients although the differential diagnosis is difficult with systemic infection. Urinary TNF-alpha was not elevated in systemic infection group, so it may be used in differential diagnosis between acute rejection and systemic infection.
Allografts* ; Cytokines ; Diagnosis ; Diagnosis, Differential ; Humans ; Interleukin-6* ; Necrosis ; Plasma* ; Tumor Necrosis Factor-alpha*

This is the report of 98 cases in renal allograft, which were treated at Yeungnam University Hospital from January 1994 to July 1996 and compared the significance of changes of TNF alpha, IL-2R, IL-6 in blood and urine as an early diagnostic tool of acute rejection in renal allograft. The aim of this study was to investigate the value of plasma and urinary TNF alpha, IL-2R, IL-6 in patients with renal allografts. Renal allografts patients were divided into four groups (control, acute rejection, acute tubular necrosis, systemic infection) according to their postoperative diagnostic methods. Blood and urine samples in four groups were obtained: control group (2 days before transplantation, at the day of transplantation and every other day after transplantation), acute rejection group (everyday sampling from 2 days before therapy to the end of therapy), acute tubular necrosis and systemic infection group (everyday sampling from the day of diagnosis to the end of therapy). In acute rejection group, there were significant elevation of cytokines; plasma TNF alpha (68.4%, p<0.01), IL-2R (73.6%, p<0.01), and IL-6 (89.5%, p<0.01), urinary TNF-alpha (42.1%, p<0.01), IL-2R (89.5%, p<0.01) and IL-6 (94.7%, p<0.01). In systemic infection group, all cytokines except urinary TNF-alpha were significantly elevated. The results suggested that plasma and urinary TNF-alpha, IL-2R, and IL-6 may play a complementary early diagnostic tool of acute rejection in renal allograft patients although the differential diagnosis is difficult with systemic infection. Urinary TNF-alpha was not elevated in systemic infection group, so it may be used in differential diagnosis between acute rejection and systemic infection.
Allografts* ; Cytokines ; Diagnosis ; Diagnosis, Differential ; Humans ; Interleukin-6* ; Necrosis ; Plasma* ; Tumor Necrosis Factor-alpha*

BACKGROUND: The relationship between infection of microorganism and atherosclerosis has been studied because the pathophysiology after infection is similar to those of cell injury and/or lipid theory. Although there are many reports which described the relationships between the infection of chalamydia pneumoniae and the atherosclerosis. In Korea, even the prevalence of chlamydia infection has not been studied yet. This study was purposed on the prevalence of chlamydia infection and it's correlation to atherosclerosis. METHODS: 235 subjects were enrolled and age and sex adjusted subjects were divided into two groups, normal controls (n=43), atherosclerosis (AS, n=90) group:coronary artery disease (CAD, n=61) and cerebrovascular disease (CVD, n=29). Serum total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C) were measured, LDL-cholesterol (LDL-C) was calculated. Serum IgG chlamydia antibody were measured by ELISA method. RESULTS: TG was significantly higher in AS (162.51+/-100.04 mg/dL vs 122.91+/-63.31 mg/dL, mean+/-SD, p=0.019), and HDL-C was significantly higher in controls (47.30+/-9.88 mg/dL vs 39.38+/-8.29 mg/dL, p<0A65A>0.01). Levels of LDL-C and TC were not statistical significant. Serum IgG chlamydia antibody was positive in 29.8% (70/235), 30% (27/90) in AS group and 28% in controls and there was no statistical significance between groups (p=0.804). CONCLUSION: In conclusion, there was no significant differences in positivity of IgG chlamydia antibody in AS compared with that of controls. Overall positivity of chlamydia antibody was lower in Korea than in other country. It is still controversial whether Chlamydia pneumoniae is a primary etiologic agent of atherosclerosis or not. This study could not demonstrate the relationship between chlamydia infection and atherosclerosis in Korea. The effectiveness and indications of antichlamydial antibiotics for prevention of cardiovascular complications in atherosclerosis and overall chlamydia infection in general population will be needed in large scale trials.
Anti-Bacterial Agents ; Arteries ; Atherosclerosis* ; Chlamydia Infections ; Chlamydia* ; Chlamydophila pneumoniae* ; Cholesterol ; Coronary Artery Disease ; Enzyme-Linked Immunosorbent Assay ; Immunoglobulin G ; Korea ; Pneumonia ; Prevalence ; Triglycerides

Supraaortic stenosis is a localized or diffuse congenital narrowing of the ascending aorta at the levels of superior margin of the sinus of Valsalva, just above coronary arteries. Hemodynamically, it is a usually manifestated as aortic stenosis especially when it combined with subaortic membrane. And there is no case report of supraaortic stenosis combined with subaortic membrane which has aortic valvular reurgitation due to secondary change of dilated sinus of Valsalva by supraaortic ridge. We have experienced a case of aortic regurgitation associated with supraaortic ridge combined with subvalvular aortic membrane.
Aorta ; Aortic Valve Insufficiency* ; Aortic Valve Stenosis ; Constriction, Pathologic ; Coronary Vessels ; Membranes* ; Sinus of Valsalva

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator