To evaluate antioxidative effect of vitamin E, selenium and zinc sulfate on release of oxygen free radicals from polymorphonuclear leukocytes[PMNs], I measured the amount of superoxide release from human PMNs stimulated by phorbol myristate acetate[PMA]with addition of some antioxidant and antioxidative micronutrients using superoxide-dependent cytochrome c reduction.And to determine a protective effect of them on cultured bovine retinal pigment epithelial cells [RPE]from oxygen radicals, I measured a viability of bovine RPE using MTT assay after incubation with human PMNs and PMA. Vitamin E, selenuim and zinc sulfate are utilized at different concentrations of 1, 10 and 20 microM. Vitamin E and zinc sulfate inhibited superoxide production from PMNs stimulated by PMA from 10 microM concentration gnificantly. But in case of selenium, significant antioxidative effect was not found at each concentration.The antioxidative effect on cultured bovine RPE was evaluated using MTT assay.Among antioxidant and antioxidative micronutrients tested, vitamin E and zinc sulfate inhibited free radical damage to bovine RPE, they increased cell survival rate on culture at concentration of 1, 10 and 20 microM. In contrast, selenium did not increase cell survival rate significantly. With these results, it was found that vitamin E and zinc sulfate had antioxidative effect against superoxide release from PMNs and also protective effect of bovine RPE from free radical damages.Recent studies supported that peroxide may play an important role in causing tissue damage in human and experimental models of ocular inflammation and possibly in Behcet`s disease.It was suggested that antioxidant vitamins and minerals like vitamin E or zinc sulfate might be useful for management and/or prevention of these conditions.
Cell Survival ; Cytochromes c ; Epithelial Cells* ; Free Radicals ; Humans* ; Inflammation ; Micronutrients ; Minerals ; Models, Theoretical ; Myristic Acid ; Oxygen ; Reactive Oxygen Species ; Retinaldehyde* ; Selenium* ; Superoxides* ; Vitamin E* ; Vitamins* ; Zinc Sulfate* ; Zinc*

PURPOSE: Anterior vaginal wall sling operation (by Raz`s method )for the treatment of stress urinary incontinence(SUI) associated with intrinsic sphincter dysfunction(ISD) may produce postoperative suprapubic discomfort and suture related problem such as pull-through and loosening. Stabilization of the bladder neck to the pubic bone decreases the tension placed on the anterior rectus fascia and lessens the possibility of suture-related pain and the risk of entrapment of ilioinguinal neve branches. At present, bone anchoring system is available in Korea but its cost sometimes limit the use of the kit. Therfore, we developed self-made titanium screw which is anchored to pubic bone at the time of anterior vaginal wall sling operation and acquired good short-term results. MATERIALS AND METHODS: Total 16 women who had SUI with ISD were treated by in-situ anterior vaginal wall sling using self-made titanium screw anchored to pubic bone to support the bladder neck and midurethra. Postoperative results were analyzed for 16 patients who has been followed up for more than 3 months after surgery. RESULTS: Overall cure rate was 100% at 3 months of follow-up. Complication included anemia in 2 patients, mild dysuria in 2 patients and osteitis pubis in 1 patient. After resting and antibiotic therapy, complications were subsided. CONCLUSIONS: In short term follow-up, anterior vaginal wall sling using self-made titanium screw was shown to be very effective treatment of SUI with ISD with simple technique and had relatively low cost, low complication rates. Long-term followup will be necessary to define the efficacy of this method.
Anemia ; Dysuria ; Fascia ; Female ; Follow-Up Studies ; Humans ; Korea ; Neck ; Osteitis ; Pubic Bone ; Suture Anchors ; Sutures ; Titanium* ; Urinary Bladder ; Urinary Incontinence*

Almost all colorectal carcinomas have been thought to develop from pre-existing adenomas. However, some colorectal carcinomas can arise directly from normal flat mucosa, and usually form infiltrative mass at the early stage. The carcinogenesis of this infiltrative carcinoma may be different from the well-known adenoma-carcinoma sequence, which usually forms a polypoid mass. The purpose of this study is to investigate the different expression of various oncogenes in polypoid carcinoma and infiltrative carcinoma. We performed immunohistochemical staining on p53, bcl-2, c-erbB-2 and MIB-1 in 29 polypoid carcinomas arised from adenomas, and 21 infiltrative carcinomas. The average tumor size of infiltrative carcinomas (5.5 cm) was larger than that of polypoid carcinomas (3.1 cm), and the polypoid carcinomas were differentiated more than the infiltrative carcinomas. The results of p53, bcl-2, c-erbB-2, and MIB-1 antisera immunoreactivity in the polypoid carcinoma were 79%, 17%, 21%, and 100%, and those in the infiltrative carcinoma were 71%, 29%, 29%, and 100%, respectively. However the diffuse positivities of p53 and MIB-1 antisera were slightly higher in the infiltraive carcinomas (62%, 76%) than in the polypoid carcinomas (55%, 41%) (p=0.63, 0.01). And the results of p53 and c-erbB-2 immunoreactivity in the adenomas were 52% and 17%, respectively, which is significantly lower than that in the polypoid carcinoma(p=0.03, 0.74). The immunoreactivty of bcl-2 in the adenoma was 72%, which was significantly higher than that in the polypoid carcinoma (17%) (p<0.01). In summary, we did not show the significant difference in expression of p53, bcl-2, c-erbB-2, and MIB-1 proteins between polypoid and infiltrative carcinomas. However, the tendency of infiltrative carcinomas having a more aggressive nature suggests another carcinogenetic mechanism is involved in the colorectal carcinogenesis.
Adenoma ; Carcinogenesis ; Colorectal Neoplasms* ; Immune Sera ; Ki-67 Antigen ; Mucous Membrane ; Oncogenes

To examine the relationship between plasma plasminogen activator inhibitor-1[PAI-1]antigen concentration and diabetic retinopathy in non-insulin dependent diabetic patients, PAI-1 antigen levels and some fibri-nolytic parameters were studied in 89 non-insulin dependent diabetic patients[mean age 59.8 +/-11.3 years]and 25 normal adults as control[meanage 52.8 +/-14.7 years]. The diabetic patients were classified as three subgroups: no DR[n=34], NPDR[n=29]and PDR[n=26]according to the degree of retinopathy.The PAI-1 antigen concentration was measured by enzyme immunoassay[Innotest PAI Ag kit].The diabetic patients had a significantly higher mean PAI-1 antigen level [34.56 +/-17.80ng/milliliter ]compared to a control group[20.35 +/-15.78 ng/milliliter ][p<0.05].Plasma PAI-1 antigen level was significantly lower in diabetic patients with PDR[27.39 +/-15.54 ng/milliliter ]than in diabetics with no DR[36.87 +/-23.31 ng /milliliter ]or NPDR[39.43 +/-2 0.17 ng/milliliter ][p<0.05], probably because of more extensive systemic endothelial damage. These results support the hypothesis that impaired fibrinolysis due to elevated PAI-1 is associated with the development of retinopathy, and therefore the levels of PAI-1 can be used as useful indicator for the development and progression of proliferative retinopathy.
Adult ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Fibrinolysis ; Humans ; Plasma* ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators

PURPOSE: To investigate the spontaneous cerebral microbleeding occurring at gradient-echo MRI, and its relationship with associated stroke lesions and risk factors. MATERIALS AND METHODS: Between September 2001 and December, 2002, 32 patients (21 men and 11 women; mean age 63 years) in whom cerebral microbleeding occurred at gradient-echo MRI were retrospectively investigated. Using a 1.5 T MR imager, spin-echo T1-weighted, fast spin-echo T2-weighted, diffusion-weighted, and gradient-echo images were obtained. The number and location of microbleeds seen on gradient echo images, patient data, and associated stroke lesions such as intracerebral hemorrhage and lacunar and territorial infarction were assessed. RESULTS: Among the 32 patients, 563 microbleeds and between 1 and 66 (mean, 17.6) were noted at gradientecho imaging. Microbleeding occurred in the cortical/subcortical area (n=216), the basal ganglia (n=173), thalamus (n=92), cerebellum (n=41), brainstem (n=36) and corpus callosum (n=1), and in 20 patients was bilateral. Patients had a history of hypertension (n=26), hypertriglycemia (n=12), heart disease (n=4), and diabetes mellitus (n=3). Stroke lesions were seen in 27 patients, intracerebral hemorrhage in ten, lacunar infarction in 24, and territorial infarction in four. CONCLUSION: The incidence and number of microbleeds was greater in older patients and in those with hypertension, hypertriglycemia, and stroke lesions such as intracerebral hemorrhage or lacunar infarction. The detection of microbleeding at gradient-echo imaging is helpful, since it predicts the possibility of cerebral hemorrhage in these patients.
Basal Ganglia ; Brain Stem ; Cerebellum ; Cerebral Hemorrhage ; Corpus Callosum ; Diabetes Mellitus ; Female ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Infarction ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Risk Factors ; Stroke* ; Stroke, Lacunar ; Thalamus

PURPOSE: To understand the characteristics of early childhood asthma, we evaluated and compared the characteristics between early persistent wheezers and late wheezers. METHODS: From January, 1998 to December, 1998, 106 children aged six to seven years were divided into three groups according to the onset of wheezing:Early persistent wheezers (n=36) who had wheezing both before three years of age and at six, late wheezers (n=48) who had no wheezing before the age of three years but had wheezing at six years, and control group (n=22) who had never wheezed at the age of six years. We performed pulmonary function and methacholine challenge tests, and measured the concentration of serum total IgE, D. pteronyssinus & D. farinae-specific IgE and total eosinophil count in these children. RESULTS: Early persistent wheezers had significantly diminished FEF25-75% than late wheezers and control group. Both early persistent wheezers and late wheezers had airway hyperresponsiveness to methacholine. Late wheezers had higher concentrations of serum total IgE than control group. The concentration of D. pteronyssinus and D. farinae-specific IgE and total eosinophil count were elevated significantly in early persistent wheezers and late wheezers than control group. CONCLUSION: Late wheezers are more closely related to atopy. Early persistent wheezers have diminished FEF25-75%, suggesting that early persistent wheezers may have abnormalities of peripheral airway. Therefore, these results strongly suggest that wheezing during childhood may be a heterogenous condition and there are apparently different two groups, early persistent wheezers and late onset wheezers, in childhood asthma.
Asthma* ; Child ; Eosinophils ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Respiratory Function Tests ; Respiratory Sounds*

Consideration of the nutritional status of patients with acute respiratory failure and mechanical ventilation is important for effective patient assessment and management. Patients with acute respiratory failure are at a high risk for developing malnutrition. High glucose intakes given during the administration of total parenteral nutrition (TPN) have been demonstrated to increase CO2 production. The workload imposed by the high CO2 production may precipitate respiratory distress in patients experiencing compromised pulmonary function. The authors report a case of successful weaning from mechanical ventilation in patient with post-operative ARDS by proper nutritional support and by changing the proportion of calories derived from carbohydrates and fats. Substitution of fat calories for carbohydrate in TNA solutions can reduce CO2 production and help wean patients from mechanical ventilation. Conclusively, the TNA (total nutrients admixture) system is more beneficial to patients with acute respiratory failure due to less CO2 production and surfactant production than TPN. For patients with hypercapnia, providing 25% to 30% of calories as carbohydrate and 50% to 55% of calories from fat may be beneficial.
Carbohydrates ; Fats ; Glucose ; Humans ; Hypercapnia ; Malnutrition ; Nutritional Status ; Nutritional Support* ; Parenteral Nutrition, Total ; Respiration, Artificial ; Respiratory Insufficiency* ; Ventilator Weaning* ; Ventilators, Mechanical* ; Weaning

OBJECTIVE: The aim of this study was to determine the relationship between the status of a unilateral palatally impacted maxillary canine (as seen on the panoramic radiograph) and the orthodontic treatment duration. METHODS: A total of 36 subjects were chosen (8 males and 28 females, 13.7 +/- 2.5 years). All patients had undergone orthodontic traction of the impacted canine after a closed flap surgery. The position of impacted canine on the panoramic radiograph was traced and calculated with regard to the treatment duration. RESULTS: The canine overlap over the lateral incisor (COGr) had significant statistical difference between the short-term and the long-term treatment duration groups (divided by average treatment time of 21 months) (p < 0.05). Multiple regression indicated that the variables of significance (with treatment duration as the dependent variable) were the canine vertical height from the occlusal plane (HCV, r(2) = 0.115; p < 0.05) and the mandibular anterior width (MnDW, r(2) = 0.142; p < 0.05). The treatment duration, the canine angle to the incisor midline (CA), and HCV decreased from primary dentition (under 12 yrs) to permanent dentition (15 yrs). Howerer, these increased again at the adolescent ages (over 16 yrs). CONCLUSION: These findings suggested that orthodontic treatment of a palatally impacted canine would show good prognosis at an age of early permanent dentition with the canine showing smaller CA and HCV.
Adolescent ; Dental Occlusion ; Dentition, Permanent ; Female ; Humans ; Incisor ; Male ; Prognosis ; Tooth, Deciduous ; Traction

The double pylorus is a rare condition consisting of a double communication between gastric antrum and duodenal bulb. Some investigators postulate that the doubling of the pyloric channel is a congenital phenornenon, but others believe that it is an acquired lesion. A 72 year-old-man was admitted to this hospital because of epigastric pain for 1 month. Upper G-I series revealed thickened rnucosal folds of pylorus and duodenal bulb and dilated, deformed duodenal bulb filled with barium materials. Endoscopic findings also showed two ovoid large openings of the pyloric channel divided by smooth thickened septum and multiple gastroduodenal ulcers. We thought that this case was an acquired lesion. The relevant literatures on the subject were reviewed.
Barium ; Duodenal Ulcer ; Humans ; Peptic Ulcer ; Pyloric Antrum ; Pylorus* ; Research Personnel ; Stomach Ulcer

Little literature exists about the risk of atypical femoral fracture in patients received zoledronic acid for prevention of skeletal metastasis. We report an atypical subtrochanteric femoral fracture in a patient with multiple myeloma received zoledronic acid. The patient was treated by closed reduction and internal fixation with cephalomedullary nailing.
Diphosphonates ; Femoral Fractures ; Humans ; Imidazoles ; Multiple Myeloma ; Nails ; Neoplasm Metastasis