No abstract available.

BACKGROUND: Stunned myocardium may be mediated by intracellular Ca2+ overloading or oxygen derived-free radicals. Halothane and propofol have been shown to block Ca2+ channels. Propofol is also known to have antioxidant properties. The present study was aimed to investigate the effects of anesthetics on recovery of postischemic, reperfused myocardium in open-chest dogs. Incidence of ventricular arrhythmia upon ischemia and reperfusion was also determined. METHODS: Forty dogs were subjected to 15 min occlusion of left anterior descending coronary artery (LAD) followed by 3 hr reperfusion during halothane (n=10), fentanyl (n=12), or propofol plus fentanyl (n=11) anesthesia. Regional contractile function was assessed using percent systolic shortening (%SS), the preload recruitable stroke work slope (Mw), and peak systolic intramyocardial pressure (IMPs). Diastolic function was evaluated using time constant for isovolumic intramyocardial pressure decline of left ventricle (IMP-tau) and percent post-systolic shortening (%PSS). RESULTS: %SS in the halothane, fentanyl, and propofol-fentanyl groups was similar at 3 hours of reperfusion (58%, 60%, and 55% of baseline value, respectively). Moreover, Mw recovered to the baseline values in the early reperfusion period in all three groups. However, IMP-tau was significantly prolonged in the halothane group throughout the 3 hour reperfusion period, whereas it remained unchanged in the fentanyl and propofol-fentanyl groups. Coronary occlusion was associated with 9, 33, and 0% mortality rate due to ventricular fibrillation upon ischemia and reperfusion in the halothane, fentanyl, and propofol-fentanyl groups, respectively. CONCLUSION: These findings indicate that halothane, but not fentanyl and propofol- fentanyl, impairs myocardial relaxation, while recovery pattern of contractile function do not differ among three groups, and that halothane and propofol reduce reperfusion arrhythmia in the canine model of myocardial stunning.
Anesthesia* ; Anesthetics ; Animals ; Arrhythmias, Cardiac ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Fentanyl* ; Halothane* ; Heart Ventricles ; Incidence ; Ischemia ; Mortality ; Myocardial Stunning* ; Myocardium ; Oxygen ; Propofol ; Relaxation ; Reperfusion ; Stroke ; Ventricular Fibrillation

The gastric adenoma, which is also called as borderline epithelial lesion, dysplasia, atypical epithelial lesion, is occasionally encoutered during gastroscopy, but the natural history of a gastric adenoma has not been clarified in view of the pre-melignant potential. In Korea, there has been few report for its gastroscopic feature, gastroscopic diagnostic accuracy, or loag-term clinical follow-up yet. (continue...)
Adenoma* ; Follow-Up Studies* ; Gastroscopy ; Korea ; Natural History

Primary intimal sarcoma of the aorta is a rare disease and has poor prognosis due to the difficulty of early diagnosis. Recently, we experienced a 42 year-old female patient who had primary intimal sarcoma of the aorta with metastasis. She complained of claudication, abdominal pain, flank pain and pulselessness. CT angiography showed thrombus-like lesion in the aorta. In our case, the transesophageal echocardiographic findings were different from those of usual thrombus, which suggested the importance of transesophageal echocardiography in the differential diagnosis of intra-aortic mass. Exploration was done because of the highly mobile portion and the biopsy revealed that the mass was intimal sarcoma. Immunohistochemical staining for actin and vimentin was positive. She died of massive gastrointestinal bleeding during admission. At autopsy, the sarcoma was found to metastasize into small intestine, kidney, and ovary.
Abdominal Pain ; Actins ; Adult ; Angiography ; Aorta* ; Autopsy ; Biopsy ; Diagnosis, Differential ; Early Diagnosis ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Flank Pain ; Hemorrhage ; Humans ; Intestine, Small ; Kidney ; Neoplasm Metastasis ; Ovary ; Prognosis ; Rare Diseases ; Sarcoma ; Thrombosis ; Vimentin

Primary intimal sarcoma of the aorta is a rare disease and has poor prognosis due to the difficulty of early diagnosis. Recently, we experienced a 42 year-old female patient who had primary intimal sarcoma of the aorta with metastasis. She complained of claudication, abdominal pain, flank pain and pulselessness. CT angiography showed thrombus-like lesion in the aorta. In our case, the transesophageal echocardiographic findings were different from those of usual thrombus, which suggested the importance of transesophageal echocardiography in the differential diagnosis of intra-aortic mass. Exploration was done because of the highly mobile portion and the biopsy revealed that the mass was intimal sarcoma. Immunohistochemical staining for actin and vimentin was positive. She died of massive gastrointestinal bleeding during admission. At autopsy, the sarcoma was found to metastasize into small intestine, kidney, and ovary.
Abdominal Pain ; Actins ; Adult ; Angiography ; Aorta* ; Autopsy ; Biopsy ; Diagnosis, Differential ; Early Diagnosis ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Flank Pain ; Hemorrhage ; Humans ; Intestine, Small ; Kidney ; Neoplasm Metastasis ; Ovary ; Prognosis ; Rare Diseases ; Sarcoma ; Thrombosis ; Vimentin

BACKGROUND AND OBJECTIVES: There are conflicting results about ciliary activity in chronic rhinosinusitis (CRS). Dynamic movements reacting to various stimuli in CRS mucosa have been rarely studied. This study was designed to investigate the dynamic ciliary activity in response to nitric oxide stimulation in sinusitis. We aimed to identify the difference in the expression of nitric oxide synthase (NOS) in normal and CRS mucosa. SUBJECTS AND METHOD: Nasal mucosal samples were obtained from 25 sinusitis and 15 normal subjects. We measured ciliary beat frequency (CBF) in the basal and activated status. Immunohistochemial staining was used to evaluate the expression of NOS in the sinusitis. RESULTS: The CRS mucosa showed marked differences in the CBF changes stimulated by NO compared to the normal mucosa; both the maximal increase and duration of increase of CBF by NO were significantly reduced in CRS mucosa. The results of immunohistochemical stain showed that eNOS expression was evident in the normal nasal mucosa and iNOS expression was markedly increased in CRS mucosa. CONCLUSION: Dynamic ciliary activity responding to NO was markedly attenuated in the CRS mucosa. The L-NAME markedly attenuated the duration of increase and maximal increase of CBF by ATP both in the normal and CRS mucosa. eNOS expression was relatively evident in the normal mucosa, whereas iNOS expression was relatively increased in the CRS mucosa, implicating different actions of NO on CBF.
Adenosine Triphosphate ; Mucociliary Clearance ; Mucous Membrane ; Nasal Mucosa ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Sinusitis

Ventricular premature complexes (VPCs) are known to be one of the most benign cardiac arrhythmias when they occur in structurally normal hearts. We experienced a 32-year old man who presented with dyspnea, palpitations and very frequent VPCs (31% of the total heart beats). Echocardiography revealed a dilated left ventricle (LV 66 mm at end-diastole and 57 mm at end-systole) and a decreased ejection fraction (34%). Very frequent VPCs had been detected 10 years previously and he underwent a failed radiofrequency catheter ablation (RFCA) procedure at that time. The patient had been treated with heart failure medications including betablockers, ACE inhibitors and spironolactone for the two most recent years. Six months after we eliminated these VPCs with a second RFCA procedure, the heart returned to normal function and size. Long standing and very frequent VPCs could be the cause of left ventricular dysfunction in a subset of patients who suffer with dilated cardiomyopathy, and RFCA should be the choice of therapy for these patients.
Ventricular Premature Complexes/*complications ; Tachycardia, Ventricular/*etiology/therapy ; Male ; Humans ; *Catheter Ablation ; Cardiomyopathies/*etiology/therapy ; Adult

Bleeding that recur or continues after hospital admission for an acutely bleeding peptic ulcer is the single most important factor adversely affecting prognosis. The endoscopic findings of stigmata of recent hemorrhage such as active bleeding, a visible vessel or fresh blood clots in peptic ulcer indicate relatively high rebleeding risk. 30 patients with stigmata of recent hemorrhage in bleeding peptic ulcers were treated by endoscopic alcohol injection therapy during the 3-year period from August 1989 to July 1992. 30 cases included 24 gastric ulcers, 4 duodenal ulcers, and 2 stomal ulcers. 8 of these were actively bleeding at the time of endoscopy and non-bleeding visible vessels were identified in 15 patients and fresh blood clots were present in 7. 12 of total 30 cases had rebleeding or continuous bleeding. 3 of 8 with active bleeding, 5 of 15 with non-bleeding bisible vessels, and 4 of 7 with fresh blood clots had rebleeding. Emergency operations were done in 4 cases. There was no complication such as perforation and mortality. We think that this modality of endoscopic hemostasis is safe and simple, but further randomized controlled trials will be needed to evaluate the efficacy of hemostasis by endoscopic alcohol injection therapy.
Christianity ; Duodenal Ulcer ; Emergencies ; Endoscopy ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; Mortality ; Peptic Ulcer* ; Prognosis ; Stomach Ulcer ; Ulcer

PURPOSE: To establish new in vitro model systems that better reflect in vivo condition, multicellular tumor spheroids(MTS) and raft culture were developed using cell lines of squamous cell carcinoma(SCCHN) of the head and neck. In these 3-dimensional systems, the expression of cell surface molecules which are important for modulation of physiology of tumor cells were studied with or without the treatment of interferon(IFN)-gamma. MATERIALS AND METHODS: Four SCCHN cell lines were used for MTS and raft culture. The effects of interferon-gamma on SCCHN cells were examined by immunohistochemistry. RESULTS: All cell lines formed MTS, but only Tu-138 showed a good stratification at the air-liquid interface in the raft culture system. Immunohistochemical studies of MTS using monoclonal antibodies revealed a strong staining for MHC class I, no staining for MHC-DR, a weak patch expression of ICAM-1 and a central strong staining for integrin a 6. Staining patterns were similar for the raft cultures except integrin a 6(intense full-thickness positivity). In both systems, IFN-gamma enhanced the expression of MHC-DR and ICAM-1. No significant change was found in the expression of MHC class I and integrin a 6. CONCLUSIONS: MTS and raft culture system were established successfully from the SCCHN cell lines. IFN-gamma can modulate the surface molecules of tumor cells in the 3-dimensional culture systems.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Cell Line ; Head* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Interferon-gamma ; Neck* ; Physiology

PURPOSE: Although the concept of "one airway, one disease," which includes the middle ear space as part of the united airway is well recognized, the role of allergens in otitis media with effusion (OME) is not clearly understood. We aimed to investigate the effect of the interaction between Dermatophagoides farinae (Der f) and lipopolysaccharide (LPS) on the induction of epithelial inflammatory response in vitro. METHODS: Primary human middle ear epithelial cells were exposed to Der f, LPS, or both in different sequences, and the magnitude of the immunologic responses was compared. The mRNA expressiona of mucin (MUC) 4, 5AC, 5B, 8, GM-CSF, TNF-α, TLR4, and MD-2 were evaluated using real-time PCR. MUC levels before and after siRNA-mediated knockout of TLR4 and MD-2 were assessed. Lastly, the involved cell signaling pathway was evaluated. RESULTS: The expressiona of cytokines, and the MUC 4, 5AC, 5B, and 8 genes were augmented by pretreatment with Der f followed by LPS; however, reverse treatment or combined treatment did not induce the same magnitude of response. Increased MUC expression was decreased by TLR4 knockdown, but not by MD-2 knockdown. The signal intensity of MUC 8 was higher in MD-2 over-expressed cells than in those exposed to LPS only. The translocation of nuclear factor-κB was observed in cells pretreated with Der f followed by LPS. CONCLUSIONS: When Der f treatment preceded LPS exposure, Der f and LPS acted synergistically in the induction of pro-inflammatory cytokines and the MUC gene, suggesting an important role in the development of OME in patients with concealed allergy airway sensitization.
Allergens ; Cytokines ; Dermatophagoides farinae* ; Ear, Middle* ; Epithelial Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans* ; Hypersensitivity ; Immunity, Innate ; In Vitro Techniques ; Lipopolysaccharides* ; Mucins ; Otitis Media with Effusion ; Pyroglyphidae* ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Toll-Like Receptors