BACKGROUND/AIMS: Hepatocytes on the hepatic lobule mipate from portal zone to centrilobular mea as the DNA synthesis within it. And also, the xenobiotic reactions reveal characteristic differences associated with zone specific metabolism in the liver acinus. In this study, the zonal distribution of ethylnitrosourea (ENU)-induced hepatic precancerous lesion was stereologically investigated. METHODS: Nine B6C3F1 mices were given I.p. injection of ENU (60 ug/pn body weight) when the pups were 15 days old prior to sacrifices at 8 weeks of life. All the 150 consecutive sections, 3 p m in thickness, were stained with hematoxylin and eosin and identified the basophilic precancerous lesions with 80-165 p m diameter in equatorial plane by the Zeiss microprojector. And then the distances from the center of selected foci to terminal hepatic vein or portal vein branches were estimated under the microscopic fields. As a control group, the same estimations were performed from the random points by the appointments of random digit table. RESULTS: Mean distance between ENU-induced 52 hepatocellular foci and the nearest terminal hepytic vein was 181.15+112.39 p m (Mean+ SD), but that of randomly selected 104 points was 291.73+157.98pm (Mean+5D) (Students t-test, p<0.0005). Substantially, 52.7% of ENU-induced 52 hepatocellular foci were within 300 p m from the terminal hepatic vein, but randomly selected 104 points were only 50.9% (Shapiro Wilk W test, w=0.819857, p=0.048038). Mean distance from ENU-induced 52 foci to portal vein was 398.85+149.98pm (Mean+SD), but that from the randomly selected 104 points was 315.87+145.79 pm (Mean+SD)(Students t-test, p<0.0005). CONCLUSION: Stereologically, ENU-induced mice liver cell foci distribute non-randomly to Zone III, centrilobular zone of mouse hepatic acini where promote invasion toward terminal hepatic veins.
Animals ; Appointments and Schedules ; Basophils ; Cholestasis ; DNA ; Eosine Yellowish-(YS) ; Ethylnitrosourea ; Fluconazole ; Hematoxylin ; Hepatic Veins ; Hepatocytes ; Liver ; Metabolism ; Mice* ; Portal Vein ; Veins

Nitric oxide(NO) has been known to play an important role as a signal molecule in many parts of the organism as well as a cytotoxic effector molecule of the nonspecific immune response. Excessive NO has been reported to exert cytotoxic effect by direct toxicity or by reacting to superoxide radicals during ischemia-reperfusion. Therefore is strongly needed a study directly measuring NO release designed to better clarify roles of NO in ischemia-reperfusion injury and its mechanism. Male Sprague-Dawley rats were anesthetized with urethane(1g/kg) intraperitoneally, and pedicled gastrocnemius muscle flaps were elevated. The elevated flaps were subjected to 4 hours of arterial ischemia and then reperfused for 2 hours. And then NO current was measured in the gastrocnemius muscle using NO-selective microelectrode system. NO release gradually increased and then decreased in the rat gastrocnemius muscle during both ischemic and reperfusion period. The average NO releases from baseline during ischemia and reperfusion were 10405 +/- 2663 and 2513 +/- 970 picoamperes(pA), respectively. The ischemia-reperfusion caused substantial histological damage in the skeletal muscle, in which a profusion of red blood cells was observed due to extravasation of vessels, rupturing of microcirculation, and leukocyte infiltration, compared to the damage in control and ischemic rat gastrocnemius muscles. From the above results, ischemia-reperfusion injury was developed more severely during reperfusion than ischemia, and NO increased during ischemia and reperfusion as a biphasic pattern in the rat gastrocnemius muscle.
Animals ; Erythrocytes ; Humans ; Ischemia ; Leukocytes ; Male ; Microcirculation ; Microelectrodes ; Muscle, Skeletal* ; Muscles ; Nitric Oxide* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Superoxides

PURPOSE: In this study, we aimed to evaluate whether nonalcoholic fatty liver disease (NAFLD) was associated with the presence and morphology of coronary atherosclerotic plaques shown by multidetector computed tomography (MDCT) in asymptomatic subjects without a history of cardiovascular disease. MATERIALS AND METHODS: We retrospectively enrolled 772 consecutive South Korean individuals who had undergone both dualsource 64-slice MDCT coronary angiography and hepatic ultrasonography during general routine health evaluations. The MDCT studies were assessed for the presence, morphology (calcified, mixed, and non-calcified), and severity of coronary plaques. RESULTS: Coronary atherosclerotic plaques were detected in 316 subjects (40.9%) by MDCT, and NAFLD was found in 346 subjects (44.8%) by hepatic ultrasonography. Subjects with NAFLD had higher prevalences of all types of atherosclerotic plaque and non-calcified, mixed, and calcified plaques than the subjects without NAFLD. However, the prevalence of significant stenosis did not differ between groups. After adjusting for age, smoking status, diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome, NAFLD remained a significant predictor for all types of coronary atherosclerotic plaque [odds ratio (OR): 1.48; 95% confidence interval (CI): 1.05-2.08; p=0.025] in binary logistic analysis, as well as for calcified plaques (OR: 1.70; 95% CI: 1.07-2.70; p=0.025) in multinomial regression analysis. CONCLUSION: Our study demonstrated that NAFLD was significantly associated with the presence and the calcified morphology of coronary atherosclerotic plaques detected by MDCT. Further prospective clinical studies are needed to clarify the exact physiopathologic role of NAFLD in coronary atherosclerosis.
Adult ; Aged ; Asian Continental Ancestry Group/statistics & numerical data ; Calcinosis/ethnology/*radiography ; Case-Control Studies ; Coronary Angiography/*methods ; Coronary Artery Disease/ethnology/pathology/*radiography ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/*methods ; Non-alcoholic Fatty Liver Disease/epidemiology/*ultrasonography ; Odds Ratio ; Plaque, Atherosclerotic/*diagnosis/epidemiology ; Prevalence ; Regression Analysis ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Ultrasonography

BACKGROUND: The purpose of this study was to analyze the endotracheal intubation cases performed in the emergency department. METHODS: We investigated retrospectively 326 cases of endotracheal intubation performed in the emergency department of a tertiary care center from April 1, 1998 to March 31, 1999. We focused on operators, medications used, its success rate and immediate complications, and the relationship between its success rate and medications. RESULTS: Of 326 consecutive intubations, 193 patients(59.2%) were done by emergency medicine residents or attending physician. While 320 patients(98.2%) were successfully intubated, 6 patients could not be intubated and 2 patients underwent tracheostomy. Of 50 cases of intubations(15.3%) attempted with paralyzing agents, 48 cases were done with succinylcholine and 46 cases underwent by emergency physicians. Intubations with neuromuscular paralysis resulted in high success rates at the first attempt. Of 55 immediate adverse events were encountered in 47 patients(desaturation=17, bronchial intubation=15, hypotension=8, bradycardia=4, cardiac arrest=2, others=5). CONCLUSION: At this institution, paralyzing agents were used infrequently, but almost all of them were used by emergency physicians.
Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Intubation ; Intubation, Intratracheal* ; Paralysis ; Retrospective Studies ; Succinylcholine ; Tertiary Care Centers* ; Tertiary Healthcare* ; Tracheostomy

OBJECTIVES: The purpose of this study was to examine the reliability and validity of A ClinicianAdministered PTSD Scale(CAPS). METHODS: CAPS was administered to 28 PTSD subjects, 30 non-PTSD subjects, and 36 normal subjects. Interrater reliability for the CAPS was established by interviewing 10 PTSD subjects. The interviews were conducted by 2 interviewers simultaneously. The authors adminstered to all the subjects Impact of Event Scale(IES), Beck Depression Inventory(BDI), State Trait Anxiety Inventory I, II (STAI-I, II) for measuring concurrent validity. RESULTS: The value of Cronbach's alpha and interrater agreement were .95 and .89, respectively. The CAPS was highly correlated with IES(r=.80), BDI(r=.70), STAI-II(r=.56). But the CAPS was not correlated with STAI-I(r=.20). The CAPS showed an overall agreement with clinical diagnosis of 82.1%. CONCLUSIONS: The CAPS shows a reasonable degree of reliability and validity. The CAPS could be a valuable tool to diagnose PTSD.
Anxiety ; Depression ; Diagnosis ; Reproducibility of Results* ; Stress Disorders, Post-Traumatic*

BACKGROUND: Facial laceration is a common clinical problem in the emergency room that is frequently associated with other craniofacial injuries. It elicits an emotional response from the patient because of the underlying concern of permanent scar and secondary facial disfigurement, so they demand prompt and adequate treatment. The aim of this study is to analyze the incidence, etiology, depth, and site of facial lacerations to provide basic data for further understanding. METHOD: This study reviewed 1,043 facial-laceration patients treated in the emergency room at Pusan Paik Hospital between March 1999 and February 2000. This retrospective study was done by reviewing and analyzing the sex and age distributions, the monthly and daily distributions, the causes of injury, the types of injury, the sites of injury, the lengths of the lacerations, and associated injuries. RESULTS: The sex ratio of men to wemen was 2.4:1, and the 0~10 age group was at the top of the age distribution. The number of patients was the highest on sundays and during March. About 9.2% of the patients visited the emergency room between 10:00 P.M. and 11:00 P.M. Falls(38.1%) were the most common cause of facial laceration, and deep laceration(51.8%) was the most common type of facial laceration. The most common laceration site was the forehead, followed by the chin and the nose. The most common associated craniofacial injury was facial bone fracture(39%). Facial-lacerations were sutured by plastic surgeons(80%), emergency physicians(10%), and oromaxillofacial surgeons(10%). We found statistical significance in the types and lengths of lacerations between men and wemen, among age groups(p<0.05). CONCLUSION: Facial laceration is one of the most common craniofacial injuries in the emergency room. By now, most lacerations have been repaired by plastic surgeons. But, the causes of lacerations are diverse and many patients are admitted due to the associated injuries. Therefore, emergency physicians should participate more aggressively in the care of facial-laceration patients to improve the outcome of the patients.
Age Distribution ; Busan ; Chin ; Cicatrix ; Emergencies* ; Emergency Service, Hospital ; Facial Bones ; Forehead ; Humans ; Incidence ; Lacerations* ; Male ; Nose ; Retrospective Studies ; Sex Ratio

No abstract available.
Leiomyosarcoma*

Tuberculosis can involve any part of the body and there are case reports of tuberculosis coexisting with malignancy in most body organs. However, cases of intestinal tuberculosis associated with colon cancer have rarely reported. Inflammatory bowel diseases can progress to malignant diseases due to mucosal dysplastic change. Similarly, intestinal tuberculosis can cause chronic inflammation, but the exact relationship between intestinal tuberculosis and colon cancer is currently obscure. A 71-year-old woman visited our hospital because of abrupt right lower abdominal pain that progressed to rebound tenderness and abdominal rigidity. Abdominal computed tomography showed a polypoid mass in the cecum and a distended terminal ileum. Right hemicolectomy was performed and the surgical specimen revealed extremely well differentiated adenocarcinoma combined with intestinal tuberculosis and bowel perforation in the cecum. We report here on a rare case of colon cancer coexisting with colonic tuberculosis and this presented as bowel perforation. We also include a review of the relevant literature.
Abdominal Pain ; Adenocarcinoma ; Aged ; Cecum ; Colon ; Colonic Neoplasms ; Female ; Humans ; Ileum ; Inflammation ; Inflammatory Bowel Diseases ; Tuberculosis

BACKGROUND: The metabolic syndrome is a cluster of related cardiovascular risk factors and it is the cause of morbidity and mortality in cardiovascular diseases. Recently, new diagnostic criteria of glucose metabolism impairment has been recommended. The purpose of this study was to estimate the difference of cardiovascular risk by investigating the prevalence of metabolic syndrome according to the degree of glucose metabolism impairment. METHODS: A population of 757 subjects was selected from a database of individuals who visited a health promotion center. We classified these subjects into 5 groups [Normal, Isolated impaired glucose tolerance (I-IGT), Isolated impaired fasting glucose (I-IFG), combined IGT with IFG (IGT/IFG) and Diabetes]. We compared the general characteristics, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the prevalence of metabolic syndrome in these groups. RESULTS: HOMA-IR and the prevalence of metabolic syndrome in the IGT/IFG and the Diabetes group were significantly greater than the Normal group. HOMA-IR and the prevalence of metabolic syndrome of the I-IGT and the I-IFG group were not significantly different with the Normal group. CONCLUSION: The insulin resistance and the prevalence of metabolic syndrome in the IGT/IFG group was significantly greater than the Normal group, and its presence may increase the risk of cardiovascular diseases. Therefore, it is important to control other combined metabolic disorders to prevent cardiovascular events after effective selection for IGT/ IFG.
Cardiovascular Diseases ; Fasting ; Glucose* ; Health Promotion ; Homeostasis ; Insulin Resistance ; Metabolism* ; Mortality ; Prevalence* ; Risk Factors

No abstract available.
Lung Neoplasms* ; Lung*