BACKGROUND: Proliferation of vascular smooth muscle cells(VSMC) is a critical event in the development of atherosclerosis. Endothelin-1(ET-1), a vasoconstrictor peptide produced by endothelial cells and VSMC, might play a role in vascular remodeling. To investigate the proposed 'mitogenic' potential of ET-1, we examined the effects of ET-1 on the proliferation if cultured porcine aortic VSMC and on the potential synergism with platelet-derived growth factor(PDGF). MATERIALS AND METHODS: VSMC were obtained from porcine aorta and cultured in Dulbecco's modified Eagle medium supplmented with 10% fetal bovine serum(FBS). VSMC grown subconfluently in 12-well plate were stimulated by ET-1, PDGF, and ET-1 & PDGF and DNA synthesis was determined as the uptake of 3H-thymidine into cell cultures. We also examined the effects of BQ123, a selective ETA receptor antagonist, and NG-methyl-L-arginine(NMLA), a nitric oxide synthase (NOS) inhibitor. RESULTS: ET-1 elicited a 2.5-fold increase of cultured VSMC DNA synthesis, comparing with basal medium, and PDGF elicited a 4.8-fold increase, whereas ET-1 and PDGF elicited a 8.8-fold increase, showing synergistic effect. Proliferative activity of ET-1 on VSMC was blocked(39%) by BQ123, however, the synergistic effect of ET-1 and PDGF was not blocked by BQ123. The synergistic effect of ET-1 and PDGF was increased when co-stimulated with NMLA. CONCLUSION: ET-1 is a co-mitogen for VSMC from porcine aorta, whose proliferative activity requires serum or other growth factors such as PDGF for its maximal activity. The proliferative activity of ET-1 is considered to be transduced partly by selective activation of the ETA receptor, however, the synergistic effect of of ET-1 and PDGF is to be stimulated by non-ETA receptor.
Aorta ; Atherosclerosis ; Cell Culture Techniques ; Cell Proliferation* ; DNA ; Eagles ; Endothelial Cells ; Endothelin-1* ; Intercellular Signaling Peptides and Proteins ; Muscle, Smooth, Vascular* ; Nitric Oxide Synthase

Neither the cause nor the correct treatment of Kienbocks disease has been clearly established, but its clinical and radiologic presentations have been distinctly defined. There are many controversies concerning therapeutic guidelines for the treatment of Kienbocks disease. The purpose of this study is to evaluate the clinical result of triscaphe fusion with radial styloidectomy of Kienbocks disease. Ten cases of stage III Kienbocks disease by Lichtmans classification were treated by triscaphe fusion with radial styloidectomy from September 1991 to March 1997. We followed up over 24 months and evaluated clinical results. In all cases, pain was relieved. The postoperative results according to Kuschners method revealed three excellent, six good and one fair. The triscaphe fusion and radial styloidectomy was considered as useful method of treatment which has clinical efficacy in Kienbocks disease.
Classification ; Osteonecrosis*

PURPOSE: To evaluate the pattern of distant lymph node metastasis in colorectal carcinoma and its correlation with distant organ metastasis. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT scans of 46 patients with pathologically proven colorectal carcinoma. RESULTS: The incidence of distant lymphadenopathy in colorectal carcinoma was 30.4%(14/46). The most commonly involved distant lymph node was the left paraortic lymph node below the renal hilum(9/25). The most common type of distant lymphadenopathy was solitary type(7/14) and all of these lymphadenopathies were noted in the left paraortic lymph node below the renal hilum. Six cases of left sided colorectal carcinoma showed left paraortic lymphadenopathy with solitary type. The incidence of distant organ metastasis was 17. 4%(8/46) and markedly increased if distant lymphadenopathy was multiple and confluent, or confluent type(5/7). CONCLUSION: The incidence of distant lymphadenopathy in colorectal carcinoma was not high and the most common lymphadenopathy was the left paraaortic lymph node with solitary type below the renal hilum. The possibility of distant organ metastasis was high if distant lymphadenopathy was multiple and confluent, or confluent type.
Colorectal Neoplasms* ; Humans ; Incidence ; Lymph Nodes* ; Lymphatic Diseases ; Neoplasm Metastasis* ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: To evaluate the MR appearance of the accessory hepatic veins. MATERIALS AND METHODS: The study included 87 consecutive patients for whom abdominal MR images were obtained. The subjects who had liver lesion or hepatic vascular abnormalities were excluded. Couinaud classified accessory hepatic veins into inferior and middle right hepatic veins. Our major interests were evaluation of the incidence, morphology, and location of the accessory hepatic vein. RESULTS: Inferior right hepatic vein was demonstrated in 43 out of 87 patients(49%). The morphology was linear in 35 patients(80.5%), and V-shaped in 8 patients(19.5%). In 40 patients(93%), the inferior right hepatic vein was located in the posteroinferior aspect of the right lobe. Middle right hepatic vein was demonstrated in 7 out of 87 patients(8%). All were single linear in morphology, combined with the inferior right hepatic vein, and located between the right hepatic vein and inferior right hepatic vein. CONCLUSION: The accessory hepatic vein was demonstrated in 49% among the Korean adult population, and was located in posteroinferior portion of the liver, in 93%.
Adult ; Hepatic Veins* ; Humans ; Incidence ; Liver ; Magnetic Resonance Imaging*

Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.
Constriction, Pathologic ; Fistula ; Forearm ; Free Tissue Flaps ; Head ; Humans ; Neck

In the present study, we investigated the differences in the levels of expression of virulence factors between blood isolates of Candida albicans and commensal strain isolated from the oral cavities of health volunteers, and correlations between virulence factors. Blood isolates of 33 and commenal isolates of 71 were characterized by putative virulence factors such as proteinase production (PROT), an ability to adhere to epithelial cells (ADH), cell surface hydrophobicity (CSH), phospholipase production (PLASE), and hyphal transition (GERM). In PROT, ADH, CSH, and PLASE, the means of expression of blood isolates were higher compared with those of commensal isolates, however statistical significance was only shown in CSH (p=0.036). On the contrary, mean expression of GERM of blood isolates was lower than that of commensal isolates. Of relationships between virulence factors, although a negative correlation of PROT with CSH was obtained, the correlation was relatively low (r=-0.316, p=0.001). These results suggest that higher expression of CSH is a more distinguishing character in virulent blood isolates of C. albicans and that the expression of virulence factors are independent.
Candida albicans* ; Candida* ; Epithelial Cells ; Healthy Volunteers* ; Hydrophobic and Hydrophilic Interactions ; Phospholipases ; Virulence Factors ; Virulence* ; Volunteers

PURPOSE: The differentiation between renal cell carcinoma(RCC) and transitional cell carcinoma(TCC) is important due to the different methods of treatment and prognosis. But occasionally it is difficult to draw a distinction between the two diseases when renal parenchyme and renal collecting systems are invaded simultaneously. MATERIAL AND METHOD: We reviewed CT scans of 37 cases of renal cell carcinoma and 12 cases of transitional cell carcinoma which showed involvement of renal parenchyma and renal sinus fat on CT. Retrospective analysis was performed by 3 abdominal radiologists. Check points were renalcontour bulging or reniform shape, location of mass center, intact parenchyme overlying the tumor, cystic change, calcification, LN metastasis, vessel invasion, and perirenal extention. RESULT:There were renal contour bulging due to the tumor mass in 33 out of 37 cases of renal cellcarcinima, wherea and nine of 12 cases of transitional cell carcinoma maintained the reniform appearance. This is significant statiscal difference between the two(p<0.005). Center of all TCCs were located in the renal sinus, and 24 out of 35 cases of RCC were located in the cortex(p<0.005). Thirty-six out of 37 cases of RCC lost the overlying parenchyma, whereas 4 out of 9 cases of well enhanced TCC had intact overlying parenchyma(p<0.005) RCC showed uptic change within the tumor mags in 31 cases which was significanity higher than the 4 cases in TCC(p<0.05). CONCLUSION: CT findings of renal cell carcinoma are contour bulging, peripheral location, obliteration of parenchyma, and cystic change. Findings of transitional cell carcinoma are reniform appearance, central location within the kidney, intact overlying parenchyma, and rare cystic change.
Carcinoma, Renal Cell* ; Carcinoma, Transitional Cell* ; Kidney ; Neoplasm Metastasis ; Pelvis* ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Gonadal Dysgenesis, 46,XY*

Paget's disease of bone (osteitis deformans), a chronic osseous disease of unknown etiology, is extremely rarein Asia although well known in western countries. This disease is characterized by the simultaneous absorption ofbone and the new bone formation of abnormal character affecting middle and later age groups. The authorsexperienced a case of monostotic Paget's disease involving left pelvic bone in 56-years old female. To ourknowledge, this is the first cas report of monostotic Paget's in Korea.
Absorption ; Asia ; Female ; Humans ; Korea ; Osteitis Deformans ; Osteogenesis ; Pelvic Bones

PURPOSE: To determine whether gadolinium enhancement is helpful in rectal tumor staging determined by MRI and using an endorectal surface coil. MATERIALS AND METHODS: Between January 1995 and July 1996, we studied 17 MRI scans in which the scanning procedure had involved the use of an endorectal coil ; this was a prostate coil in six patients, and a colon coil in eleven. Eight patients were male and nine were female ; they were aged between 39 and 77 (mean, 59) years, and the tumors which had presented were adenocarcinoma (n=15), lymphoma (n=1) and villous adenoma (n=1). Precontrast scanning showing invasion of the rectal wall and perirectal fat were interpreted, and postcontrast T1WI and pathological findings were then compared. Fifteen patients underwent surgical resection but the other two (one adenocarcinoma and one lymphoma) underwent only an endoscopic biopsy. RESULTS: On precontrast scanning with the prostate coil, accurate staging was possible in three cases (one of stage T2, and two of stage T3) ; we overstaged two cases of stage T2 as stage T3. On postcontrast T1WI, however, we additionally understaged one case of stage T3 as stage T2. In a case of adenocarcinoma proven by biopsy, no definite difference was noted between pre- and postenhanced scan. On precontrast scan using a colon coil, accurate staging was possible in six cases (two of stage T1, one of stage T2 and three of stage T3). We overstaged a case of stage T2 as stage T3 and understaged three cases of stage T3 as stage T2. On postcontrast T1WI, however, we accurately diagnosed one additional case of stage T3, not diagnosed on precontrast scan. In one case of bioptically-proven lymphoma, no definite difference was noted between pre- and postenhanced scan. CONCLUSION: In rectal tumor staging, pre- and postenhanced scans are both 60% accurate. In MRI using an endorectal surface coil, gadolinium enhancement is not, therefore significantly helpful.
Adenocarcinoma ; Adenoma, Villous ; Biopsy ; Colon ; Female ; Gadolinium* ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Male ; Prostate ; Rectal Neoplasms*