The mechanism of cytolysis by complement attack of nucleated cells(NC) is of special interest in comparison to that of red blood cells. It is known that NC death by membrane attack comples, C5b-9, is caused by many factors, i.e., efficiency of complex assembly, activation of intrinsic metabolic pathway by signal transduction, cytotoxic effect of the channel itself and natural repair ability. These factors suggest that colloid osmotic lysis, known in red blood cells, does not fully explain the complement-mediated cell death of NC. In this study, the authors investigated correlation between biochemical and morphological changes to prove "Ca2+-mediated metabolic death"8~13) representing a mechanism of NC death caused by C5b-9 attack. The L1210 cells, mouse leukemic cell line carrying small complement channel(TAC5b-91) were used in the experiments. The amounts of intracellular adenine nucleotides to extracellular Ca2+, ouabain, KC1 and dextran were analyzed by bioluminescence method using luminometer. Cell viability was checked by 0.4% trypan blue dye and LDH release. Morphological observation of TAC5b-91 was done by immunocytochemical staining and electron microscope. The results were as follows: 1) The release of ATP, ADP and AMP followed by cell death was rapid and progressive along the incubation time at 37 degrees C and it was accelerated in 1.5 mM of [Ca2+]0. 2) There was no evidence of ATP repairment in the TAC5b-91. 3) Extracellular KC1(150 mM), dextran(0.66 mM) and ATP supplement(0.2 microM) could not effectively inhibit ATP depletion and cell death. Ouabain(27 and 100 microM) enhanced cell death and could not completely prevent ATP loss. 4) Most of the mitochondria showed swelling, loss of cristae and Ca2+ deposit in matrix in the electron microscopic observation. Rapid, sustained and irreversible depletion of adenine nucleotides was due to Ca2+ deposit with destruction of mitochondria and also the leakage through transmembrane channels. Moreover this energy depletion was accelerated by high extracellular Ca2+ concentration. These results indicate that Ca2+-mediated, energy exhaustion is one of the mechanisms of the metabolic cell death by C5b-9 attack of NC.
Mice ; Animals

Mucocele of the appendix is uncomrnon and rarely diagnosed preoperatively. The malignant rountpart-i.e. mucinous cystadenocarcinoma--has the same grross appearance and many micro scopic features in cornmon wilhe the benign form. It rnay be associated with ovarian mucinous cystadenoma of strikingly similar microscopic appearence. A serious complication is a rupture of the mucoeele resulting in pseudomyxoma peritonei. Each case of benign and malignant mucocelr of the appendix falsely diagnosecl as an oovarian tumor before laparotxumy are presented wilh a brief rieview of the literatures.
Appendix* ; Cystadenoma, Mucinous ; Mucins ; Mucocele* ; Pseudomyxoma Peritonei ; Rupture

Primary aortoenteric fistula (PAEF) is a rare but catastrophic cause of gastrointestinal bleeding. The diagnosis of PAEF is difficult to make. The classic triad of symptoms, i.e. gastrointestinal bleeding, abdominal pain, and a pulsating abdominal mass is overemphasized, as it occurs in less than 11~25% of the patients. For two thirds of the patients, the diagnosis is made in the operating room. Endoscopic and radiographic studies are very helpful, but the absence of abnormalities can not exclude the diagnosis. PAEF is a clinical and surgical challenge associated with high mortality. A high index of suspicion, early diagnosis and prompt and appropriate surgical intervention are essential to patient survival. Two primary aortoenteric fistulas (aortoduodenal and aortoesophageal) cases are presented and the related literature are reviewed.
Abdominal Pain ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Early Diagnosis ; Fistula ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Fistula ; Operating Rooms ; Vascular Fistula

PURPOSE: This paper is to evaluate radiological features of hypersensitivity pneumonitis, correlated with clinical and pathologic findings. MATERIALS AND METHODS: Patients consisted of 2 men and 3 women, aged 23-51 years old (average 41). Diagnosis was based on the presence of suggestive clinical and radiological findings (chest radiography, high resolutional CT, gallium scintigraphy), and lung biopsy showing characteristic histological features. RESULTS: All patients complained of exertional dyspnea and three patients experienced coughing. On the pulmonary function test, four patients revealed restrictive pattern and one patient was normal. Results of bronchoalveolar lavage, available in four patients, revealed lymphocytosis in three patients and normal finding in one patient. Chest radiographs showed ground glass opacity or diffuse nodular densities. On the HRCT, diffuse nodular opacity and ground glass opacity were seen in variable features. All 4 patients had diffuse increased uptake on the gallium scan. On lung biopsy, a combination of histologic findings showed cellular bronchiolitis, diffuse interstitial infiltrates and non-necrotizing granulomas, consistent with diagnosis of hypersensitivity pneumonitis. CONCLUSION: Hypersensitivity pneumonitis could be diagnosed with these radiological, clinical and pathological findings.
Alveolitis, Extrinsic Allergic* ; Biopsy ; Bronchiolitis ; Bronchoalveolar Lavage ; Cough ; Diagnosis ; Dyspnea ; Female ; Gallium ; Glass ; Granuloma ; Humans ; Hypersensitivity* ; Lung ; Lymphocytosis ; Male ; Radiography ; Radiography, Thoracic ; Respiratory Function Tests

The purpose of this study was to investigate the maximum effect and effective instillation time interval of 5% NaCl on the corneal edema. Onetenth ml of 2% lidocaine was injected intracamerally to make the corneal edema at right eyes of four rabbits, but any manipulation was not done on the left eyes. Twelve hours after the operation, one drop of 5% NaCl was instillated in both eyes and the central corneal thickness(CCT)was measured every 30 minutes until the three successive records had no demonstrable changes compared to baseline levels. Maximum effect on normal cornea and corneal edema showed at 60 minutes after the instillation of one drop of 5% NaCl;the CCT decreased by about 5% compared to preopertaive level. To evaluate the effective instillation time interval, twenty eyes of 20 white rabbits were randomly divided into 5 groups and 0.1 ml of 2% lidocaine was injected intracamerally at right eyes. In control group, they were remained without any medications and showed natural course of corneal edema. 7In group 1, they were treated with 5% NaCl every 30 minutes and in group 2, 60 minutes, in group 3, 120 minutes, and in group 4, 180 minutes. Using a ultrasonic pachymeter, CCT was measured at 30 minutes interval up to 360 minutes. In group 1, decrease of the CCT was found to be more than 5% at 60 minutes after treatment and there was 5.00~7.24% decrease of CCT up to 360 minutes. In group 2 and 3, decrease of the CCT more than 5% was found at 90 minutes after treatment and there was 3.95~6.07% decrease of CCT up to 360 minutes.In group 4, decrease of the CCT more than 5% was found at 90 minutes after treatment and there was severe fluctuation of the decrease of the CCT from 2.47% to 6.78% up to 360 minutes. In group 1, decrease of the CCT was larger than that of the others, but there was chances of the corneal epithelial toxicity and incovenience due to frequent instillation. In group 2 and 3, there was no difference between the two groups in the amounts of the decrease of the CCT, but in terms of convenience, instillation every 2 hours(120 minutes)was recommendable. Treatment with 5% NaCl every 2 hours on corneal stromal edema with normal epithelial barrier function can decrease the CCT and induce good maintenance effect.
Cornea ; Corneal Edema* ; Edema ; Lidocaine ; Ophthalmic Solutions* ; Rabbits ; Ultrasonics

OBJECTIVE: This clinical study was carried out to evaluate the effect of premature rupture of the membranes (PROM) on neonatal sepsis in infants who were delivered more than 35 weeks of gestational age (GA). METHODS: Clinical data were collected from 125 newborns of mothers with PROM who were delivered more than 35 weeks of GA at Chonnam National University Hospital during the five-year period from January 1998 to December 2002. RESULTS: The incidence of PROM was 15.4% with little yearly variations and PROM in which GA more than 35 weeks was 3.5%. The incidence of positive C-reactive protein (CRP), neonatal fever and neonatal sepsis were not increased but the neonatal use of antibiotics was increased in relation to the duration of the PROM. In the patients with neonatal sepsis, positive CRP rate and incidence of neonatal and maternal fever were significantly high, and use of maternal antibiotics was significantly low. CONCLUSION: When the newborns of mothers with PROM were delivered more than 35 weeks of GA, maternal history of fever or antibiotic treatment and neonatal history of fever, blood culture and CRP should be checked regardless of duration of PROM, and then begin to start antibiotics according to the baby's clinical signs and symptoms.
Anti-Bacterial Agents ; C-Reactive Protein ; Fever ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Jeollanam-do ; Membranes* ; Mothers* ; Rupture* ; Sepsis

BACKGROUND: To elucidate the mechanism of interaction between depolarizing and nondepolarizing muscle relaxants, train-of-four (TOF) fade during onset of neuromuscular blockade of d-tubocurarine (dTC) with or without decamethonium (C10) was evaluated in a rat phrenic nerve hemidiaphragm preparation. METHODS: Phrenic nerve hemidiaphragm preparations from 250~300 g Sprague Dawley rats (n=20) were suspended in a Krebs solution bubbled with 5% CO2 in O2 at 32oC. Phrenic nerves were stimulated with supramaximal stimuli of 0.2 ms duration at 0.15 Hz single twitch and 2 Hz TOF by a Grass S88 stimulator and the contractions of the hemidiaphragm were detected by a Grass FT03 force transducer then recorded. Estimation of ED50 for the dose response data were performed by a linear regression. The statistical significance of the results was determined by Wilcoxon Rank Sum test. p<0.05 was considered significant. RESULTS: Mean ED50 values of dTC and C10 calculated from the dose response relations were 7.76 microgram/ml and 0.65 microgram/ml respectively. Compared to adminstration of 2xED50 of dTC alone, TOF ratios at 75% and 50% of twitch height were markedly decreased by combination of ED50 of C10 and ED50 of dTC with statistic significance (67 +/- 1.9% vs. 46 +/- 3.1% and 36 +/- 2.5% vs. 7 +/- 2.5%). Conclusion: If fade in response to TOF stimulation represents a prejunctional effect, the results from this study suggests that the presynaptic action of C10 has some role in the mechanism of the interaction between dTC and C10 in the rat.
Animals ; Linear Models ; Neuromuscular Blockade* ; Phrenic Nerve* ; Poaceae ; Rats* ; Rats, Sprague-Dawley ; Transducers ; Tubocurarine*

Trisomy 9 mosaic syndrome is a rarely reported chromosomal abnormality with high incidence of intrauterine growth retardation and perinatal death. Even a baby lives, he has severe mental retardation and significant malformations. The incidence and severity of malformations and mental retardation correlate with the percentage of trisomic cells in the different tissues. The characteristic craniofacial abnormalitis are narrow bifrontal diameter, up-slanted and short palpebral fissures, a prominent nasal bridge with a short root, a prominent lip covering a receding lower lip, low-set, posteriorly rotated, and misshapen ears. Ventricular septal defect is a main cardiac abnormality. Bony hypoplasia and dislocated hips have been frequently reported. Central nervous system, hepatobiliary, gastrointestinal and genitourinary abnormalities also had been reported. The authors report a baby who had characteristic abnormalities of trisomy 9 mosaicism with narrow temples, up-slanted palpebral fissures, a bulbous nose, thin and protruding upper lip, low set and malformed ears, hyperextended wrist and overlapping fingers. Cytogenetic analysis performed to confirm the chromosomal abnormality revealed trisomy 9, low level mosaic type.
Central Nervous System ; Chromosome Aberrations ; Cytogenetic Analysis ; Ear ; Fetal Growth Retardation ; Fingers ; Heart Septal Defects, Ventricular ; Hip ; Incidence ; Intellectual Disability ; Lip ; Mosaicism* ; Nose ; Trisomy* ; Urogenital Abnormalities ; Wrist

No abstract available.
Female ; Humans ; Ovary*

PURPOSE: The aim of this study is to correlate the non-characteristic dual-phase CT imaging findings of hepato-cellular carcinoma with the observed characteristics of surgical specimens. MATERIALS AND METHODS: We studied four cases in which homogeneous low attenuation was observed during the arterial and delayed phases of dynamic CT scanning and in which hepatocellular carcinoma with coagulation necrosis above 95% was pathologically confirmed. We compared the findings of dual phase CT scanning, ultrasonography, angiography and Lipiodol CT scanning with the observed features of surgical specimens. RESULTS: Nodules were 30-50 (mean, 41) mm in size, and were round in three cases and oval in one. In all four cases, a low density lesion was observed during the arterial and delayed phases of dual-phase CT scanning. Ultrasonography demonstrated internal echo and the presence of a hypoechoic halo, implying that in all cases a capsule was present. At angiography and LiCT, minimal peripheral and central tumor staining or lipiodol up-take was observed. In all surgical specimens a complete capsule was visible, and histologic structures were mainly of the trabecular type, Edmondson grade II or III was recorded, and the mass had undergone extensive coagulation necrosis (above 95%). CONCLUSION: In cirrhotic liver which is hepatitis B-antigen positive, clear sonographic findings of internal echo and a capsule, rather than a simple cyst, indicate the possibility of hepatocellular carcinoma with extensive coagulation necrosis. This is so even if the arterial and delayed phases of dual-phase CT scanning indicate the presence of a low-density lesion, and in such cases additional work-up is therefore required.
Angiography ; Carcinoma, Hepatocellular* ; Diagnosis* ; Ethiodized Oil ; Hepatitis ; Liver ; Liver Neoplasms ; Necrosis* ; Tomography, X-Ray Computed ; Ultrasonography