PURPOSE: To analyze the variable MRI features and clinical significance of intracranial cavernous realformation. MATERIALS AND METHODS: Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso- or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6months). RESULTS: Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type 11, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. CONCLUSION: Cavernous realformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to predict natural course and possibility of rebleeding of the lesion.
Classification ; Edema ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Thrombosis

BACKGROUND: The electrophysiological effects of purinergic receptor agonists, adenosine triphosphate(ATP) and adenosine were examined using conventional microelectrode technique in rat atrial muscle fibers under superfused with a normal or a simulated ischemic(hypoxic, hyperkalemic and acidotic) physiologic salt solution(PSS) in vitro. METHODS: Action potential parameters, such as maximal diastolic potential(MDP), action potential amplitude(APA), rate of phase 0 depolarization(dv/dtmax) and action potential duration(APD90) were measured in electrically paced, physiologic salt solution(Tyrode's) superfused left rat atrium. In the experiment of ischemic simulation in vitro, normal physiologic salt solutions(NPSS0 were modified(MPSS) and superfused in substitute for normal Tyrode's solution. To investigate the effects of purinergic receptor agonists, ATP or adenosine was added to the superfused tyrode's solutions(NPSS or MPSS) in molar concentration. RESULTS: Under superfused with normal PSS, ATP(10(-3), 10(-4)M) elicited slight hyperpolarization in MDP, and both ATP(10(-6)-10(-3)M) and adenosine(10(-6)-10(-3)M) shortened the duration of normal action potential in a dose-dependent manner. The other paramaters were not affected by the drugs. Superfusion with ischemic PSS caused reductions in MDP as well as APA, dv/dtmax and, especially, APD90. The effects produced by the initial 10 minutes of superfusion with ischemic PSS almost completely disappeared during a subsequent period of continued superfusion with normal PSS, but, those by the initial 20 min lasted in some degree. Both ATP(10(-4)M) and adenosine(10(-4)M) attenuated the reduction in the rate of phase 0 depolarization and the amplitude of the action potential amplitude produced by the ischemic PSS. CONCLUSION: Purinergic receptor agonists, ATP and adensoine, caused a concentration-dependent shortening of the action potential duration in rat atrial muscle fibers and they attenuated the reductions in the rate of phase 0 depolarization and action potential amplitude in fibers superfused with ischemic PSS.
Action Potentials ; Adenosine ; Adenosine Triphosphate ; Animals ; Ischemia ; Microelectrodes ; Molar ; Purinergic Agonists* ; Rats ; Receptors, Purinergic

The clinical resemblance of carcinoma of the Meibomian gland to the relatively frequent chaiazion should be kept in mind by anyone performing eye lid surgery. A 46-year-oId Korean house wife was first visited here in May 2nd '69 with complaints of localized swelling, ulceration and dull pain on the left upper lid. She had been taken the operation for chaiazion on the same side of the left upper eye lid a year ago. Examination revealed a reddened hard, tender lesion elevating the skin on the medial one third of the left upper lid with ulceration at its center. The tarsal conjunctiva was noted yellowish patches with ulceraion extended to its margin. Local resection with full thickness containing normal tissue around he lesion of upper lid was performed and graft was made in lower lid and rotatory transplantation was given, and pathologic examination revealed adeno-carcinoma of Meibimian gland. There was no evidence of recurrence and metastasis to remote site a year after surgery.
Adenocarcinoma* ; Conjunctiva ; Humans ; Meibomian Glands* ; Neoplasm Metastasis ; Recurrence ; Skin ; Spouses ; Transplants ; Ulcer

No abstract available.
Arthritis* ; Knee*

Luteal phase defect (LPD) is an ovulatory disorder of considerable clinical importance that leads to delayed endometrial maturation and inadequate endometrium for blastocyst implantation. This disorder is implicated in infertility and recurrent spontaneous abortion. We analyzed the endometrial histological maturation, and the estrogen receptor(ER) and progesterone receptor(PR) status in patients with unexplained delayed ovulation, and in patients with ovulation induction by clomiphen citrate. The purpose of this study was to determine whether the length of the follicular phase influences the endometrial histological maturation and the hormonal receptor status, and to know the effect of clomiphen citrate on the endometrium. In the delayed ovulation group, the endometrium was characterized by an irregular outpouching and dilated lumina of the glands, a decreased secretory activity and predecidualization, and a decreased number of granulocytes in the stroma. In the clomiphen citrate-ovulation induction group, glandular proliferation was markedly diminished with poorly convoluted and narrow glands, secretory activity was decreased, stroma was undecidualized, and there was an absence of granulocytes. ER expression was increased in the glandular epithelium in the delayed ovulation group, and both ER and PR expressions were markedly decreased in the glandular epithelium and stromal cells in the ovulation induction group. Endometrial maturation and differentiation may be diminished by increased estrogenic and relatively deficient progesterone effects in patients with delayed ovulation. The hormonal receptor status might also be influenced by hormonal changes. Clomiphen citrate successfully induced ovulation in patients with delayed ovulation, however, endometrial proliferation and maturation were markedly suppressed. This might be related to the lower pregnancy rate and higher abortion rate in patients with clomiphen citrate induced ovulation.
Pregnancy ; Female ; Humans

BACKGOUND: Transforming growth factor-beta (TGF-alpha) has been implicated in the pathogenesis of a number of kidney diseases. However, TGF-alpha is secreted in a latent form requiring extracellular modification to become biologically active. Recently, the activity of TGF-alpha has been assessed by the measurement betaig-h3, a novel TGF-alpha induced gene product. Thus we evaluated the pattern of urinary betaig-h3 expression in various glomerular diseases. METHODS: 64 patients with biopsy-proven primary glomerulonephritis (FSGS 6, HSPN 16, IgAN 20, MPGN I 7, and MesPGN 15), 10 patients with nephrotic syndrome and 12 healthy controls were enrolled in the study. A total 86 subjects (51 males, 59.3% and 35 females, 40.7%, mean age 13.9+/-4.28 years) constituted study population. First morning urine were collected and betaig-h3 in the urine was determined by indirect competitive ELISA (Regen Biotech Inc, Seoul, Korea). RESULTS: betaig-h3 excretion was significantly higher in the urine from patients with HSPN (27.5+/-6.46, p=0.002), with IgAN (40.83+/-12.27, p=0.026), with MPGN I (21.64+/-7.29, p=0.042), MesPGN (26.42+/-6.68, p=0.007). In patients with FSGS (21.65+/-17.12) and minimal change nephrotic syndrome (6.26+/-2.18), mean urinary betaig-h3 excretion was not significant higher than that in control group (3.56+/-0.78). CONCLUSION: Urinary betaig-h3 excretion was high in proliferative renal diseases. However, betaig-h3 excretion was not high in non-proliferative renal diseases.
Enzyme-Linked Immunosorbent Assay ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Humans ; Kidney Diseases ; Male ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Seoul ; Transforming Growth Factor alpha

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

Primary ovarian choriocarcinoma is an extremely rare germ cell neoplasm, and the prognosis is poor. Especially, the diagnosis of primary ovarian nongestational chori-ocarcinoma can be reliably established in a girl or innocent virgin. We report a case of primary ovarian, nongestational, pure choriocarcinoma in a 16-year-old woman. She died within 1 year after diagnosis in spite of the treatment with surgery and combin-ation chemotherapy.
Adolescent ; Choriocarcinoma ; Choriocarcinoma, Non-gestational* ; Diagnosis ; Drug Therapy ; Female ; Germ Cells ; Humans ; Pregnancy ; Prognosis

No abstract available.
Diagnosis* ; Hemoglobinuria*