Ischemic colitis still remains largely underdiagnosed despite the fact that it is one of the most common disorders of the large bowel. The aims of the present study were to evaluate the variable histologic findings of ischemic colitis and to find out helpful histopathological features in diagnosis. Retrospective review of the clinical symptoms, underlying diseases, endoscopic findings of 23 patients, and the histologic features of 37 biopsies was done. We analyzed the significant pathologic features in the histologically diagnosed ischemic colitis group and compared the biopsy time between the histologically diagnosed ischemic colitis group and the non-diagnosed group. Comparison of the endoscopic biopsy time between the group that showed significant histologic features and the group that showed no significant histologic features was also done. The age of the patients ranged from 27 to 87 years. Most patients had abdominal pain, hematemesis, and melena. Endoscopic differential diagnoses included ischemic colitis, ulcerative colitis, infectious colitis, tuberculous colitis, Crohn's disease, and pseudomembranous colitis. Histologic features and diagnoses were also variable. The coagulative necrosis of mucosa and the epithelial desquamation were frequently detected in the group pathologically diagnosed as ischemic colitis. The most pathognomonic finding was coagulative necrosis of the mucosa that was almost always detected within seven days after the onset of clinical symptoms. Recognition of variable patterns of ischemic colitis in a biopsy specimen will direct the clinician to evaluate the vascular system. Early endoscopic biopsy is essential for the precise diagnosis of ischemic colitis.
Abdominal Pain ; Biopsy* ; Colitis ; Colitis, Ischemic* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Enterocolitis, Pseudomembranous ; Hematemesis ; Humans ; Melena ; Mucous Membrane ; Necrosis ; Retrospective Studies

No abstract available.
Carbon Monoxide* ; Carbon*

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

No abstract available.
Gestational Age* ; Mortality

No abstract available.
Animals ; Interleukin-2 ; Mice*

We examined the p53 protein overexpression and evaluated its correlation with pathobiological variables, including: (1) patient age, sex, tumor size, histological type and grade, invasion depth, vascular invasion, perineural invasion and lymph node status; (2) the Ki-67 labeling index in 100 gastric carcinomas; and (3) the DNA ploidy pattern, S phase fraction (SPF), and the proliferation index (PI) in 84 cases using flow cytometry. The positive rate of p53 staining was 48% and the p53 immunoreactivity was independent of variable clinicopathologic factors. No correlation was made between the Ki-67 labeling index with p53 immunostaining and DNA ploidy parameters. Aneuploidy rate was slightly higher in the p53 positive group (55.6%) than the p53 negative group (44.4%)(p=0.097). The mean values of SPF and PI were significantly higher in the p53 protein positive group. Aneuploidy was more often observed in the intestinal type (p=0.038), advanced gastric carcinoma (p=0.015) and lymph node positive group(p=0.039). The above results suggest that although the p53 protein overexpression has no significant correlation with pathological factors and the Ki-67 labeling index, it may play an important role in tumor cell proliferation. Since p53 protein overexpression was slightly higher in the aneuploidy group showing significant correlation with poor prognostic parameters, it is thought that re-evaluation of the p53 mutation by molecular biological study is needed.
Aneuploidy ; Cell Proliferation ; DNA* ; Flow Cytometry ; Humans ; Lymph Nodes ; Ploidies* ; S Phase

No abstract available.

PURPOSE: The purpose of this study is to evaluate the findings of magnetic resonance imaging(MRI) of posterior fossa hemangioblastoma and usefulness of contrast enhancement with Gd-DTPA. MATERIALS AND METHODS: Seven patients with posterior fossa hemangioblastoma were studied with both pre- and post-enhanced MRI. The MR images were reviewed regarding the location, size, signal intensities of cysts and mural nodules, and their contrast enhancement pattern. RESULTS: Five tumors were located in cerebellar hemisphere, one in vermis, and one in posterior part of medulla. One patient with von HippeI-Lindau disease had a medullary hemangioblastoma with multiple pancreatic cysts. In 6 cases, the major portion of the tumor was cysts and had small mulkal nodules. The solid portion was relatiely lange in one case, cemprising half of the tumor Cysts were oval shaped and their sizes were 3--6.7cm in diameter. In five cases(71%), septations were noted within the cysts. Cysts were isointense or slightly hyperintense on Tl-weighted image and hyperintense on T2-weighted image compared with cerebrospinal fluid. Mural nodules were oval or rounded appearance in five cases and flattened appearance in two, and their size was 0.5--2.5cm in diameter. Mural nodules were isointense to gray matter. They were detected in five cases on Tl-weighted images and one case on T2-weighted images. In two cases, vascular signal void area was noted in mural nodules. On contrast-enhanced Tl-weighted images, all mural nodules were intensely enhanced. CONCLUSION: MRI proved to be a good diagnostic method to detect and characterize posterior fossa hemangioblastoma. The most common finding is Cystic posterior fossa lesion with enhancing mural nodule. Contrast enhancement is essential for specific diagnosis.
Cerebrospinal Fluid ; Diagnosis ; Gadolinium DTPA ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging* ; Pancreatic Cyst

PURPOSE: This study was performed to evaluate differentiating features of spinal compression fractures between benign and metastatic lesions. MATERIALS AND METHODS: We reviewed MR imaging in 52 patients (benign 38, metastasis 14) with vertebral compression fracture. Signal intensity of fracture and uninvolved areas, presence of contrast enhancement, fragmentation, and paravertebral mass were analyzed retrospectively. RESULTS: Signal intensity of fracture site was variable in benign lesions, but low signal intensity on T1-weighted image and high on T2*-weighted image were seen in all cases of metastasis. Signal intensity of uninvolved area was high on T1-weighted image and low on T2*-weighted image in 84% of benign lesions. On the contrary, normal marrow signal intensity was not seen in the uninvolved areas of all metastatic fractures. Contrast enhancement were observed in all cases of benign & metastatic compression fractures. Fragmentation were seen in 1 case of metastasis(7%) and in 11 cases of benign lesions(29%). Paravertebral mass were seen in 5 cases of metastasis(36%) and in 7 cases of benign lesions(18%). CONCLUSION: Presence of normal marrow signal intensity in the uninvolved area of fracture site could be the most useful sign for differentiating benign causes from metastasis.
Bone Marrow ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging* ; Neoplasm Metastasis* ; Retrospective Studies

BACKGROUND: Aging is associated with increased cardiovascular risk and firmly established as a risk factor for the development of atherosclerosis. However the exact mechanism of age-related damage to the arterial wall and its relation to the atherosclerotic process are not well known.The endothelium plays an important role for the regulation of vascular tone and the endothelial function is impaired in the presence of risk factors early in the process of atherosclerosis. Assessment of endothelial function appears to be a valuable tool for the diagnosing and therapeutic monitoring of coronary artery disease. Anti-oxidants are known to improve endothelial dysfunction in atherosclerosis patients. The aim of this study was, (1) to evaluate the endothelial function in elderly, (2) to investigate whether vitamin C administration has benefit on the endothelial function in elderly. METHODS: The endothelial function was estimated using venous occlusion plethysmography(VOP) in 7 elderly and 7 young healthy volunteers. The strain guage was connected to plethysmograph to record the forearm volume change. A rapid cuff inflator was used to inflate the arm cuff to 40 mmHg instantaneuosly thus occluding venous return from the forearm. The measurement of forearm volume change was repeated for 7 times each stage. The change of the forearm blood flow(FBF) was measured with the acetylcholine infusion through brachial artery and also with intra-arterial vitamin C. RESULTS: Endothelium-dependent vasodilatation was significantly impaired in the elderly group compared to the young group(321 +/-17% in elderly group vs 509 +/-81%, mean+/-SEM) Forearm blood flow response to acetylcholine was significantly enhanced with inraarterial infusion of vitamin C in elderly group(321+/-17% in elderly group vs 78% in vitamin C) Coinfusion of L-NMMA, an inhibitor of nitric oxide synthase, blunted forearm blood flow response to acetylcholine. CONCLUSIONS: Even though the mechanisms leading to drpressed endothelial function in elderly remains to be elucidated, our study shows that vitamin C result in demonstrable improvement by a mechanism that is probably related to antioxidant activity.
Acetylcholine ; Aged* ; Aging ; Arm ; Ascorbic Acid* ; Atherosclerosis ; Brachial Artery ; Coronary Artery Disease ; Endothelium ; Forearm ; Healthy Volunteers ; Humans ; Nitric Oxide Synthase ; omega-N-Methylarginine ; Risk Factors ; Vasodilation* ; Vitamins*