No abstract available.
Constriction* ; Heart Ventricles* ; Pulmonary Artery* ; Rabbits*

OBJECTIVE: To elucidate the location of leptin and receptors of ovary specimens obtained from patients undergoing hysterectomy by immunohistochemical staining and to determine the effect of leptin on the steroidogenesis of cultured granulosa cells. METHOD: In the culturing process of the granulosa cells, FSH (1 IU/ml)and leptin (50 ng/ml), IGF-I (50 ng/ml) was administered to each study group (Group I: FSH; Group II: FSH, leptin; Group III: FSH, IGF-I, leptin), and the levels of estradiol, progesterone, androstenedione in the culture media was measured by radioimmunoassay. Statistical analysis was conducted by one-way ANOVA with Scheffe test. RESULTS: The results showed that leptin and leptin receptors were both found to be strongly stained in granulosa and theca cells, and also in some interstitial cells. Leptin receptors were also observed in cultured granulosa cells. While there was no statistically significant difference in the androstnedione concentrations between the groups, estradiol concentrations was significantly decreased in Group IV (2202.0+/-151.14 pg/ml) compared to Group III (2859.0+/-122.6 pg/ml), and progesterone concentrations were also significantly decreased in Group II(4696.3+/-190.6 ng/ml) and Group IV (4517+/-206.78 ng/ml) compared to Group III(5546.0+/-179.5 ng/ml). CONCLUSTION: The study result of this study suggest that leptin is directly involved in the regulation of ovarian functions, in particular steroidogenesis.
Androstenedione ; Culture Media ; Estradiol ; Female ; Granulosa Cells* ; Humans* ; Hysterectomy ; Insulin-Like Growth Factor I ; Leptin* ; Ovary ; Progesterone ; Radioimmunoassay ; Receptors, Leptin ; Theca Cells

Wilms' tumor is one of the most common primary malignant tumors of the kidney during infancy and childhood and is known to be originated from the primitive cells of metanephric blastema. It presents difficulties when encountered in deciding the presence of anaplasia or in differentiating it from other renal tumors of childhood with different biologic behavior because of its diverse histologic patterns and varying degrees of differentiation. Evaluation of clinical and histopathologic features in terms of prognostication was done of 32 cases of Wilms' tumor which were surgically resected and diagnosed in the period from January 1979 through June 1992. Immunohistochemical reaction for cytokeratin, vimentin, actin and desmin was also analysed on all cases of Wilms' tumor in conjunction with clear cell sarcoma of the kidney(CCSK), malignant rhabdoid tumor of the kidney(MRTK) and congenital mesoblastic nephroma(CMN) to assess the validity of immunohistochemistry in differentiating Wilms' tumor from these renal tumors. Twenty four(75%) cases were diagnosed before the age of 5 and 40.7% were under 2 years old. Mixed type was most common(62.5%), followed by epithelial, blastemal and stromal predominant type in descending order of frequency. Anaplasia was observed in 3 cases(9.4%), two of which were epithelial predominant type and one blastemal predominant type. Treatment modality and presence of anaplasia were significantly correlated with 5 year survival rate of patients. Immunohistochemical stain revealed that all epithelial component of Wilms' tumor were positive for cytokeratin and 56.3% of Wilms' tumor had blastemal component which were positive for both cytokeratin and vimentin. Twenty cases(62.5%) of Wilms' tumor had blastemal component which were positive for cytokeratin with a proportion of more than 5% of reactive cells. Stromal component of Wilms' tumor generally did not show differentiation into the specialized type of tissue and all revealed positive reactions for vimentin among which some revealed positive reactions for actin. Only 3 out of 6 cases with rhabdomyoblastic differentiation were positive for desmin. CCSK, MRTK and CMN which have different biologic behavior and treatment modality compared to Wilm's tumor showed positivity only for vimentin and/or actin. In summary, treatment modality and presence of anaplasia are significantly correlated with patients' survival and the immunohistochemical stain for cytokeratin is very helpful in confirming the presence of blastemal component and useful in the differential diagnosis of Wilms' tumor from other kinds of pediatric renal tumors.
Child ; Male ; Female ; Humans ; Diagnosis, Differential

Among the types of gastric cancer, the proportion of early gastric cancer has shown a steady increase because the national screening programs have been conducted in Korea. Accordingly, the paradigm shift of the treatment procedure from surgical gastrectomy to endoscopic resection for selected early gastric cancer has accelerated recently. For successful treatment of early gastric cancer, early detection is essential to accurately predict the histological type, depth of invasion, and horizontal margins of the tumor.Current Concepts: The diagnosis of early gastric cancer and selection of treatment procedures comprises the following steps: (1) presence diagnosis, (2) qualitative diagnosis, and (3) quantitative diagnosis. Presently, early gastric cancer diagnosis is based on the endoscopic detection of a demarcated lesion and irregularity of the mucosal surface or color pattern. If a lesion is diagnosed as early gastric cancer, qualitative and quantitative diagnostic processes should be conducted. Qualitative diagnosis predicts the histological type (differentiated vs. undifferentiated), whereas quantitative diagnosis predicts the invasion depth and horizontal margins of the lesion. The diagnostic processes are based on the macroscopic morphology and color of the lesion, while sometimes using chromoendoscopy, image-enhanced endoscopy, and magnifying endoscopy.Discussion and Conclusion: If gastric cancer is detected at an early stage, most cases can be treated only by endoscopic resection. Therefore, endoscopists should have systematic knowledge regarding the findings of early gastric cancer for timely detection and appropriate selection of the treatment procedure.

OBJECTIVES: To develop a new immunohistochemical marker system for supplementation of the Noyes histological classification of the endometrium in women of child bearing age with regular menstrual cycles, and to employ this system to evaluate pathologic factors involved in endometriosis, and thus to ascertain if it is useful in diagnosis. MATERIALS AND METHODS: Endometrial biopsies were sampled from the posterior fundus of 41 (24 proliferative phases, 17 secretory phases) women with regular menstrual cycles (28-32 days), and each sample was immunhistochemically stained according to Noyes et al (1975) for determination of expression for extrogen receptor (ER), progesterone receter(PR), integrin alpha1, alpha4, beta3, COX-1 and COX-2. Then, the PR, the integrin beta3, and COX-2 which were clearly expressed in the luteal phase was with endometrial samples were obtained from 20 cases of normal patients (group 1) and 25 cases with endometriosis (group 2) after confirming the day of ovulation by sex steroid level measurements 7-8 days after ovulation. RESULTS: In the regular menstruation group the expression of ER showed a tendency to be increased in the proliferative phase and decreased in the secretory phase, and was the highest in the proliferative phase. However, PR in the stromal cells showed no change in the entire menstrual cycle while in the epithelial cells, PR reached a peak in the late proliferative phase and was almost absent in the secretory phase. Integrin alpha 1, alpha4, and beta3 expression in the epithelial cells was absent in the proliferative phase but alpha1 was expressed strongly in the early and mid secretory phases and disappeared in the late proliferative phase, while beta3, appeared after the mid secretory phase and continued to be expressed until the late secretory phase. Expression in the stromal cells was weak overall and did not show any cyclic pattern. COX-1 expression was shown as a cyclic pattern in the stromal and epithelial cells and was partcularly strongly expressed in the mid secretory phase of epithelial cells, and in the mid secretory and menstruation phase of stromal cells. In the endometrial epithelial cells there was strong expression during the entire cycle with stronger expression in the secretory phase compared to the prolferative phase. COX-2 was clearly expressed in the late proliferative, early and mid secretory phased in the stromal cells. No expression was observed in the proliferative phase of the epithelial cells, but which began to appear in the early secretory phase reaching a significant pattern from the mid secretory phase onwards. There was almost no expression in the stromal cells. In the cases with endometriosis showing normal endometrial maturation according to the Noyes classification, PR expression was increased while Integrin-beta3 expression was significantly decreased compared to the normal group. Also, COX-2 expression was slightly decreased in the stromal cells of patients with endometriosis while it was significantly increased in the stromal cells. CONCLUSION: Immunohistochemical markers can supplement the original Noyes classification of histological endometrial dating and therefore ascertain existing pathologic conditions. Particularly for patients with endometriosis with normally mature endometrial cells, changes in COX-2 and integrin expression patterns may assist in elucidating pathophysiologic mechanisms and therefore aid in the diagnosis of abnormal implantation conditions, and consequently determine a treatment modality.
Biopsy ; Child ; Classification ; Diagnosis ; Endometriosis* ; Endometrium* ; Epithelial Cells ; Female ; Humans* ; Integrin alpha1 ; Integrin beta3 ; Luteal Phase ; Menstrual Cycle ; Menstruation ; Ovulation ; Progesterone* ; Prostaglandin-Endoperoxide Synthases* ; Receptors, Progesterone* ; Stromal Cells

OBJECTIVE: We compared the expression pattern of progesterone receptor, integrin 3, cyclooxygenase-2 (COX-2) in in-phased endomerium of patient with the disease related implantation and control group, and tried to confirm the clinical efficacy of the immunohistochemical markers for discrimination of occult uterine receptivity defect in in-phase endometrium. STUDY DESIGN: Endometrial tissues were obtained from 60 women with normal (group 1; n = 20), uterine synechiae (group 2; n = 15), and endometriosis (group 3; n = 25). On 7 ~ 8 days after ovulation (POD 7 ~ 8), sex hormone levels were measured and immunohistochemical staining of PR, integrin 3, and COX-2 expression were performed. RESULTS: PR was decreased in the group 2 and increased in the group 3 comparing with the group 1. integrin 3 expression was significantly decreased in the group 2 and 3. COX-2 expression was significantly decreased in the group 2. But, in the group 3, COX-2 expression was slightly increased in glandular epithelial cells, and significantly increased in stromal cells. CONCLUSIONS: In-phase biopsies from patients with endometriosis and uterine synechiae showed different expression pattern of integrin 3, COX-2, and PR compared to the control. The aberrant expression of immunohistochemical markers be associated with occult uterine receptivity defect and produce the useful diagnostic method.
Biopsy ; Cyclooxygenase 2* ; Discrimination (Psychology) ; Endometriosis ; Endometrium* ; Epithelial Cells ; Female ; Gynatresia ; Humans* ; Ovulation ; Progesterone* ; Receptors, Progesterone* ; Stromal Cells

Trichuriasis is an intestinal infection of human beings caused by Trichuris trichiura, more commonly known as whipworm because of its whip-like appearance. It is characterized by the invasion of the colonic mucosa by the adult trichuris. It is prevalent throughout the world, especially in tropical areas. Diagnosis is made typically by the identification of characteristic barrel-shaped eggs in the feces, although adult worms may be seen rarely at sigmoidoscopy or colonoscopy. We report five cases of whipworm infection that was diagnosed on colonoscopic examination.
Adult ; Colon ; Colonoscopy ; Diagnosis* ; Eggs ; Feces ; Humans ; Mucous Membrane ; Ovum ; Sigmoidoscopy ; Trichuriasis ; Trichuris

We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia's syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.
Airway Management ; Anesthesia, General* ; Follow-Up Studies ; Hoarseness ; Humans ; Hypoglossal Nerve ; Methods ; Neck ; Paralysis ; Spine* ; Tongue ; Vagus Nerve

Endoscopic injection sclerotherapy(EIS) is currently the most widely practiced method for treating and eradicating acutely bleeding esophageal varices in repeated sessions, but may be associated with some uadesirable local and systemic complications. Endoscopic variceal ligation(EVL), which consists of mechanical ligation and thrombosis of varices using elastic "0"- rings, has been recently developed as a non-operative alternative to EIS. We performed EVL in 16 patients who had recently bled from esophageal varices. Total 249 variceal ligations were performed during 71 separate EVL sessions. Three patients were actively bleeding at initial EVL; all of them were successfully controlled by emergency EVL. During the study period two patients died after initial EVL; one who refused te return for repeated EVL died from rebleeding, the other died from hepatic failure without any rebleeding. Rebleeding, following initiation of EVL, occured in 3 patients(l8.8%); two patients had bled from varices except previousiy ligated site and were successfully controlled by emergency EVL, remained one who refused any repeat endoscopy could not be confirmed the bleeding site. Varices were eradicated or reduced to grade I in 10(71.4%) of the 14 survivors by 14-28 ligations(mean, 19.5 ligations) in 3 -7 EVL sessions(mean, 5.4 sessions), During or after EVL, there were no complications, except transient mild dysphagia in 3 patients of 16 patients. These results indicated that EVL is a safe and effective method for treatmet of bleeding esophageal varices.
Deglutition Disorders ; Emergencies ; Endoscopy ; Esophageal and Gastric Varices* ; Hemorrhage* ; Humans ; Ligation* ; Liver Failure ; Survivors ; Thrombosis ; Varicose Veins

Spontaneous herniation of the spinal cord is a rare disease entity in which spinal cord substance is herniated through a previously uninjured and/or untouched dura. It is a cause of myelopathy that is treatable but difficult to diagnose. We report the CT and MR findings of a case of spontaneous thoracic spinal cord herniation manifesting as ventrolateral protrusion of thoracic spinal cord through a dural defect.
Rare Diseases ; Spinal Cord Diseases ; Spinal Cord*