The left ventricular radial strain in the inner and outer layers was evaluated by using two-dimensional speckle tracking imaging (2DS). Twenty-five piglets were studied. The short axis views were acquired. Peak systolic radial strain was measured from 6 circumferential points related to 6 standard segments in the inner and outer layers respectively using 2DS methods. The peak positive first derivative (dp/dt) of left ventricular pressure was compared to the radial strain from 2DS. The inner band showed higher peak radial strain values as compared to the outer band at all of the segments (P<0.0001), but the differences had significance just in anteroseptal, posterior, inferior and septal segments (P<0.05). Good correlation could be found between radial strain of inner and outer layers and peak dp/dt (P<0.001). These preliminary results showed that the degree of local deformation or wall thickening of the ventricular wall in its inner layer was more obvious than its outer layer. It is suggested that the 2DS technique is useful and sensitive for better understanding the regional and global myocardial motion and its relationship to the complex architecture of myocardium.

Linear scleroderma is a variant of localized scleroderma which may occur in the head, trunk and extremities, affecting variously the skin, subcutaneous tissue, muscle, cartilage and bone. Particularly, scleroderma en coup de sabre is the descriptive term denoting linear scleroderma of the frontoparietal area of the scalp and face. We report a case of severe scleroderma en coup de sabre with ipsilateral body atrophy(total hemiatrophy) who underwent multidisciplinary assessment and required both two-jaw surgery and groin free flap to correct the underlying skeletal deformities and augment the facial soft tissues. The reason for classifying this as a case of scleroderma en coup de sabre in preference to Parry-Romberg syndrome is because of the striking clinical features seen in this patient.
Atrophy* ; Cartilage ; Congenital Abnormalities ; Extremities ; Facial Hemiatrophy ; Free Tissue Flaps ; Groin ; Head ; Humans ; Scalp ; Scleroderma, Localized ; Skin ; Strikes, Employee ; Subcutaneous Tissue

The aim of the present study was to investigate the modulatory role of activated 5-HT(3) receptors in the central amygdala (CeA) on mitogen concanavalin A (ConA)-stimulated proliferative response of thymocytes in rats and the underlying neuroendocrine regulation circuits. 1-phenylbiguanide (PBG), a putative selective 5-HT(3) receptor agonist, was administered by intraperitoneal (i.p.), bilateral intracerebroventriclular (i.c.v.), and bilateral intracentral amygdala (i.c.a.) injection. In addition, thymocytes isolated from untreated rats were incubated with PBG (at a range of concentrations of 1x10(-8)-1x10(-5) mol/L) in vitro in the presence and absence of ConA, in order to investigate any direct effect of PBG on the proliferation in vitro. MTT method was applied to demonstrate the effect of PBG on the proliferative response of thymocytes. An immunohistochemical SABC assay was used to describe the expression profiles of c-Fos-positive cells in different brain regions including the CeA, hippocampus, cortex, hypothalamus and periaqueductal gray (PAG) at 1, 2, 4 and 8 h after bilateral single-administration of PBG by i.c.a. (1.0 microg/side). Results showed that PBG (1x10(-8)-1x10(-5) mol/L) had no significant influence on the proliferative responses of the isolated thymocytes in vitro, no matter ConA was present or not. The proliferation of thymocytes stimulated by ConA was not significantly changed when PBG was administered by i.p. (0.5 mg/kg per day, for consecutive 5 d), whereas it was remarkably enhanced after bilateral i.c.v. injection of PBG (10 microg/side per day, for consecutive 5 d). Similarly, when PBG was injected bilaterally by i.c.a. (1.0 microg/side per day, for 1 d or consecutive 3, 5 and 7 d), a significantly enhanced proliferation occurred on the 1st day and continued until reaching its peak on the 5th day before decreasing on the 7th day. All of the promoting effects of PBG on the ConA-stimulated proliferation of thymocytes were reversed by pretreatment with the 5-HT(3) receptor antagonist tropisetron (TRP) 5 min prior to the administration of PBG. Interestingly, compared to the treatment with normal saline or TRP + PBG, after a bilateral single-administration of PBG (1.0 microg/side) by i.c.a., the number of c-Fos-positive cells in different brain regions significantly increased at 1 h in the CeA, 1-2 h in the hippocampus, 1-2 h in the cortex, 4 h in the hypothalamus and 8 h in the PAG, respectively, with each maximum response at 1 h in the CeA, 2 h in the hippocampus and cortex, and 4 h in the hypothalamus. Subsequently, the number of cells expressing c-Fos gradually reduced to the minimum at 4 h in the CeA, and at 8 h in the hippocampus, cortex and hypothalamus. In conclusion, the 5-HT(3) receptors in the CeA of rats mediate the modulation of thymus function, at least partly, through the neuroendocrine circuit of the limbic system-cortex-hypothalamus-PAG.
Amygdala ; metabolism ; physiology ; Animals ; Male ; Neuroimmunomodulation ; physiology ; Rats ; Rats, Sprague-Dawley ; Receptors, Serotonin, 5-HT3 ; metabolism ; physiology ; Thymus Gland ; cytology ; physiology

INTRODUCTION: Hydatidiform mole (HM) is an abnormal gestation characterized by significant hydropic enlargement, trophoblastic proliferation and atypia involving part or all of the chorionic villi. The diagnosis and classification of hydatidiform moles is subject to great inter-observer variability due to significant morphologic overlaps. This study aims to evaluate the utility of p57KIP2 immunohistochemistry and ploidy by Her-2 FISH in refining the diagnosis of molar tissues.

METHOD: 113 and 78 molar cases were retrieved from the archives of the Histopathology Section of the Philippine General Hospital and Pathology Department of Seoul National University Hospital, respectively. TMA sections were submitted for immunohistochemical analysis for p57KIP2. Ploidy was determined by fluorescence in situ hybridization using Her-2 probe. An interrater reliability analysis was done using the Kappa statistics with 95% confidence interval.

RESULTS: All 68 (100%) cases diagnosed as CH were negative for p57KIP2 staining and are diploid. Among the 54 cases of PH, only 1 (2%) is positive for p57KIP2 and is diploid. The interrater reliability between p57KIP2 and Her-2 FISH ploidy results is 0.66 (p <.0.001), 95% CI (0.02, 1.00) which is considered "fair to good." The kappa value between review diagnosis and p57KIP2 is 0.024 while the kappa between review diagnosis and Her-2 FISH ploidy is 0.050 both signifying poor agreement beyond chance.

CONCLUSION: Morphologic assessment alone may not be sufficient in problematic cases. p57KIP2 in conjunction with by Her-2 FISH are good adjuncts in the diagnosis and classification of hydatidiform mole.

Human ; Male ; Female ; Pregnancy ; Chorionic Villi ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Diploidy ; Reproducibility Of Results ; Hydatidiform Mole ; Trophoblasts ; Ploidies ; Molar

This paper summarizes our experience of five cases of sick-sinus syndrome, hospitalized at Presbyterian Medical Center in Jeonju from January, 1980 to January, 1983. Diagnosis was made depending on clinical symptoms, physical examination, EKG and provocative test with atropine sulfate. The etiologies of 4 cases were as follows: coronary disease, hypertension, myocarditis, coronary disease with hypertension; but, the etiology of one case was not clear. Symptoms, including syncope, dizziness, and palpitation subsided after implanting the temporary pacemaker. A permanent pacemaker was implanted in all but one case, who had myocarditis.
Atropine ; Coronary Disease ; Diagnosis ; Dizziness ; Electrocardiography ; Hypertension ; Jeollabuk-do ; Myocarditis ; Physical Examination ; Protestantism ; Syncope

BACKGROUNDThe association between the infection of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Treponema denticola in chronic periodontitis (CP) and the severity of periodontal disease remains to be elucidated. The aim of this study was to investigate the subgingival infection frequencies of three periodontopathic bacteria in Chinese CP patients and to evaluate the correlations between infection by these bacteria and periodontal destruction.

METHODSA multiple PCR assay using primers derived from 16SrDNA genes of P. gingivalis, A. actinomycetemcomitans and T. denticola was established to measure simultaneously the presence of the three microbes in 162 subgingival samples from 81 Chinese CP patients.

RESULTSThe positive rates of P. gingivalis, A. actinomycetemcomitans and T. denticola in the subgingival samples were 84.6%, 83.3% and 88.3%, respectively. Of the subgingival samples, 68% revealed the coinfection of all the three microbes. The infection rates with P. gingivalis, A. actinomycetemcomitans or T. denticola alone was 5.9% (1/17), 17.6% (3/17) and 76.5% (13/17), respectively. A close association was present between the A. actinomycetemcomitans infection and gingival index (GI) (P < 0.01), but not between P. gingivalis or T. denticola infection and GI (P > 0.05). P. gingivalis and A. actinomycetemcomitans were more frequently detectable in middle and deep pockets than in shallow ones (P < 0.01), while T. denticola was found remarkably often in deep pockets (P < 0.05). The coinfection rate of the three microbes was significantly higher in sites with severe periodontitis than in those with mild periodontitis (P < 0.01).

CONCLUSIONSThe multiple PCR established in this study can be used as a sensitive and specific method to simultaneously detect all three microbes in subgingival samples. A. actinomycetemcomitans infection may be associated with CP and play an important role in the periodontal tissue destruction. The coinfection of P. gingivalis, A. actinomycetemcomitans and T. denticola can cause more serious periodontal destruction than infection of any one or two of the three microbes.

Adult ; Aged ; Aggregatibacter actinomycetemcomitans ; genetics ; isolation & purification ; Chronic Disease ; DNA, Ribosomal ; analysis ; Dental Plaque ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Periodontitis ; microbiology ; pathology ; Periodontium ; pathology ; Polymerase Chain Reaction ; Porphyromonas gingivalis ; genetics ; isolation & purification ; RNA, Ribosomal, 16S ; genetics ; Treponema denticola ; genetics ; isolation & purification

Hand dermatitis is commonly seen in primary care, although it is often underdiagnosed. Exogenous causes should always be considered and a detailed environmental and occupational history taken, especially in patients presenting in adulthood. Although not life-threatening, the condition may have significant impact on the patient's quality of life and employment. Refractory cases or those suspected to be due to exogenous workplace agents may need to be referred for further investigation. Hand dermatitis can be treated effectively using pharmacotherapy and prevented by minimising subsequent exposure to irritants and allergens. Occupational skin disorders, once diagnosed, should be notified to the relevant authorities, i.e. the Ministry of Manpower in Singapore.
Adult ; Dermatitis, Irritant ; diagnosis ; Dermatitis, Occupational ; diagnosis ; therapy ; Eczema ; diagnosis ; therapy ; Female ; Hand ; pathology ; Humans ; Occupational Diseases ; diagnosis ; therapy ; Primary Health Care ; methods ; Singapore

The cystic fibrosis transmembrane conductance regulator (CFTR) is a unique member of the ATP-binding cassette (ABC) transporter superfamily that forms a Cl(-) channel with complex regulation. CFTR is composed of five domains: two membrane-spanning domains (MSDs), two nucleotide-binding domains (NBDs) and a unique regulatory domain (RD). The MSDs assemble to form a low conductance (6-10 pS) anion-selective pore with deep intracellular and shallow extracellular vestibules separated by a selectivity filter. The NBDs form a head-to-tail dimer with two ATP-binding sites (termed sites 1 and 2) located at the dimer interface. Anion flow through CFTR is gated by the interaction of ATP with sites 1 and 2 powering cycles of NBD dimer association and dissociation and hence, conformational changes in the MSDs that open and close the channel pore. The RD is an unstructured domain with multiple consensus phosphorylation sites, phosphorylation of which stimulates CFTR function by enhancing the interaction of ATP with the NBDs. Tight spatial and temporal control of CFTR activity is achieved by macromolecular signalling complexes in which scaffolding proteins colocalise CFTR and plasma membrane receptors with protein kinases and phosphatases. Moreover, a macromolecular complex composed of CFTR and metabolic enzymes (a CFTR metabolon) permits CFTR activity to be coupled tightly to metabolic pathways within cells so that CFTR inhibition conserves vital energy stores. CFTR is expressed in epithelial tissues throughout the body, lining ducts and tubes. It functions to control the quantity and composition of epithelial secretions by driving either the absorption or secretion of salt and water. Of note, in the respiratory airways CFTR plays an additional important role in host defence. Malfunction of CFTR disrupts transepithelial ion transport leading to a wide spectrum of human disease.
Cystic Fibrosis Transmembrane Conductance Regulator ; physiology ; Epithelium ; physiology ; Humans ; Ion Transport ; Phosphorylation ; Protein Interaction Domains and Motifs

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Bacteremia ; drug therapy ; Cefazolin ; therapeutic use ; Drug Resistance, Bacterial ; Female ; Humans ; Klebsiella Infections ; drug therapy ; Klebsiella pneumoniae ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Retrospective Studies ; Young Adult

Phospholipase D (PLD) is an enzyme involved in signal transduction and widely distributed in mammalian cells. The signal transduction pathways and role for phospholipid metabolism during hormonal response in cortical collecting duct remain partly undefined. It has been reported that dexamethasone increases transepithelial transport in M-1 cells that are derived from the mouse cortical collecting duct. We investigated the expression and activity of PLD in M-1 cells. Basal PLD activity of M-1 cells cultured in the presence of dexamethasone (5 microM) was higher than in the absence of dexamethasone. Dexamethasone and ATP activated PLD in M-1 cells but phorbol ester did not stimulate PLD activity. Vasopressin, bradykinin, dibutyryl cyclic AMP, and ionomycin were ineffective in activating PLD of the cells. The PLD2 isotype was detected by immunoprecipitation but PLD1 was not detected in M-1 cells. Addition of GTPgammaS and ADP-ribosylation factor or phosphatidylinositiol 4,5-bisphosphate to digitonin-permeabilized cells did not augment PLD activity. In intact cells PLD activity was increased by sodium oleate but there was no significant change between dexamethasone treated- and untreated cells by oleate. These results suggest that at least two types of PLD are present in M-1 cells and PLD plays a role in the corticosteroid-mediated response of cortical collecting duct cells.
Animal ; Biological Transport/drug effects ; Dexamethasone/pharmacology* ; Dose-Response Relationship, Drug ; Drug Interactions ; Glycerophospholipids/analysis ; Isoenzymes/drug effects ; Kidney Cortex/cytology ; Kidney Tubules, Collecting/drug effects* ; Kidney Tubules, Collecting/cytology ; Mice ; Mice, Transgenic ; Oleic Acid/pharmacology ; Phospholipase D/drug effects*