The functional and morphologic cardiac developments are determined by the morphogenesis, growth and remodeling of the heart resulted from the cell proliferation and apoptosis. We studied the distribution of the proliferation and apoptotic activity of myocardial cells according to the developmental stages in embryos of C57bl/6 mice. Serial histologic sections were stained with PCNA and TUNEL method and were analyzed with image analyzer (BMI, Seoul). The ventricular myocardium of an embryonic heart could be divided into trabecular, inner compact and outer compact layers. Proliferation indices at layers of the left ventricular myocardium on embryonal days (ED) 13, 14, 16, 17 and 18 were 19.9%/47.4%/60.4%, 16.1%/45.8%/60.3%, 24.6%/45.6%/38.1%, 23.3%/17.7%/18.3% and 31.2%/28.0%/19.4% (trabecular/ inner compact/ outer compact) and the right ventricle, 11.0%/34.4%/60.5%, 23.0%/44.0%/69.0%, 29.2%/42.9%/35.1%, 30.4%/30.5%/22.3% and 32.4%/28.4%/16.3%. The apoptotic indices of the left ventricle/VIF were 0.23%/3.66% on ED 13-14, 0.42%/1.31% on ED 16 and 0.05%/0.60% on ED 17-18. The results show that the proliferation of the myocytes was maximal at the outer compact layer on ED 13 and 14 but lowest on ED 17 and 18. This decrease was more pronounced at the left ventricle. The innermost trabecular layer showed a constant proliferation activity of 11.0-32.4%. The presence of spatiotemporal differences in the cell proliferation reveals regional regulation in the developmental timing of cardiac development. Functional maturation is considered to be responsible for the change of proliferation activity. The apoptosis was most frequent and intense in the VIF and crux throughout the periods of each embryonal day where as rarely seen in the ventricular myocardium, especially in the trabecular layer of myocardium. These findings suggest that the apoptosis plays the role in the development of atrioventricular, ventriculoarterial septation and valve formation. Our results also reveal that the participation of apoptosis in formation of the trabeculation can be denied.
Animals ; Apoptosis* ; Cell Proliferation* ; Embryonic Structures ; Heart ; Heart Ventricles ; In Situ Nick-End Labeling ; Mice ; Morphogenesis ; Muscle Cells ; Myocardium ; Proliferating Cell Nuclear Antigen

BACKGROUND: It is important to evaluate the patient presenting with non-traumatic chest pain in emergency department, and it is also difficult to classify appropriately. The purpose of this study is to predict probability of acute myocardial infarction(AMI) and assess the group for low probability of AMI that is target for observation-unit of chest pain in emergency department. METHODS: A prospective, clinical study was performed from March 1998 to August 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. We classified high-probability group and low-probability group of AMI according to Goldman's algorithm and then compared with the final diagnosis. RESULTS: The study included 218 patients. 84 patients(39%) was the high-probability group and 134 patients(61%) was the low-probability group of AMI. As compared with final diagnosis, AMI was 47 patients(56%) among the high-probability group and 1 patient(0.7%) among the low-probability group. We observed sensitivity of 98%, specificity of 78% in predicting AMI. CONCLUSION: The classification according to Goldman's algorithm may be useful predictor of AMI and improve triage for emergency department patient with chest pain. It is also helpful for management of observation-unit of chest pain in emergency department.
Chest Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Thorax* ; Triage

PURPOSE: The pathogenesis of carotid atherosclerosis (CA) is known to involve several pathologic processes, such as lipid disturbances, thrombosis, oxidative stress and apoptosis. However, the genetic factors contributing to the development of CA, are, poorly understood. Thus, this study was performed to clarify the genes that are related with CA by comparing the expression patterns of mRNA in the arteries of a control group and in the arteries of a CA patients group. MATHODS: The total RNAs in the arteries of both groups were obtained from the abdominal aorta of 5 brain death donors and also the carotid arteries of 10 CA patents, and the DNAs were then reversely transcribed into complementary DNA (cDNA). The annealing control primer (ACP) method was applied to identify the differentially expressed messenger RNAs (mRNAs). RESULTS: The prominently expressed genes in the CA group compared with the control group were those of apolipoprotein C1 (apoC1) and ferritin light chain (FTL). There was a difference in the gene and protein expressions in the development of vascular disease between the coronary and carotid arteries, i.e., the transcriptional pathway for the FTL expression in CA patient arteries, and the posttranscriptional pathway in the coronary artery disease. The ApoC1 gene was another prominently expressed gene in the current study, and it has been reported to promote apoptosis in the cultured smooth muscle cells of human aorta. CONCLUSION: The increased expression of the apoC1 and FTL genes in the carotid artery might increase the possibility of CA via the apoptosis and oxidation of the increased LDL and VLDL.
Aorta ; Aorta, Abdominal ; Apoferritins ; Apolipoprotein C-I ; Apoptosis ; Arteries ; Brain Death ; Carotid Arteries ; Carotid Artery Diseases* ; Coronary Artery Disease ; DNA ; DNA, Complementary ; Humans* ; Myocytes, Smooth Muscle ; Oxidative Stress ; Pathologic Processes ; RNA ; RNA, Messenger ; Thrombosis ; Tissue Donors ; Vascular Diseases

Asthma exacerbations are a major cause of intractable morbidity, increases in health care costs, and a greater progressive loss of lung function. Asthma exacerbations are most commonly triggered by respiratory viral infections, particularly with human rhinovirus (hRV). Respiratory viral infections are believed to affect the expression of indoleamine 2,3-dioxygenase (IDO), a limiting enzyme in tryptophan catabolism, which is presumed to alter asthmatic airway inflammation. Here, we explored the detailed role of IDO in the progression of asthma exacerbations using a mouse model for asthma exacerbation caused by hRV infection. Our results reveal that IDO is required to prevent neutrophilic inflammation in the course of asthma exacerbation caused by an hRV infection, as corroborated by markedly enhanced Th17- and Th1-type neutrophilia in the airways of IDO-deficient mice. This neutrophilia was closely associated with disrupted expression of tight junctions and enhanced expression of inflammasomerelated molecules and mucin-inducing genes. In addition, IDO ablation enhanced allergenspecific Th17- and Th1-biased CD4 + T-cell responses following hRV infection. The role of IDO in attenuating Th17- and Th1-type neutrophilic airway inflammation became more apparent in chronic asthma exacerbations after repeated allergen exposures and hRV infections. Furthermore, IDO enzymatic induction in leukocytes derived from the hematopoietic stem cell (HSC) lineage appeared to play a dominant role in attenuating Th17- and Th1-type neutrophilic inflammation in the airway following hRV infection. Therefore, IDO activity in HSC-derived leukocytes is required to regulate Th17- and Th1-type neutrophilic inflammation in the airway during asthma exacerbations caused by hRV infections.

PURPOSE: The purpose of this study is to analyze the measurement differences of simple radiographs according to radiation projection angle using a phantom and to propose methods for objective analysis of simple radiographs. MATERIALS AND METHODS: We took simple radiographs with different projection angles using a C-arm image intensifier and measured five parameters of the foot on the simple radiographic images. Five parameters include lateral tibiocalcaneal angle, lateral talocalcaneal angle, naviculocuboid overlap, lateral talo-first metatarsal angle, and lateral calcaneo-first metatarsal angle. Intraobserver and interobserver reliability were verified, and then intraclass correlations of parameters were analyzed. RESULTS: Radiographic parameters of the foot showed high intraobserver and interobserver reliability. Lateral tibiocalcaneal angle has a strong negative linear relationship with rotation and a moderate negative linear relationship with tilt. Lateral talocalcaneal angle has a moderate positive linear relationship with rotation and a strong positive linear relationship with tilt. Naviculocuboid overlap has a strong positive linear relationship with rotation and a moderate positive linear relationship with tilt. Lateral talo-first metatarsal angle does not have a linear relationship with rotation and a moderate negative linear relationship with tilt. Lateral calcaneo-first metatarsal angle has a moderate positive linear relationship with rotation and tilt. CONCLUSION: More precise evaluation of the foot with a simple radiograph can be performed by understanding the changes of radiographic parameters according to radiation projection angle.
Foot* ; Metatarsal Bones ; Phantoms, Imaging ; Radiography

Calcium pyrophosphate dihydrate (CPPD) deposition disease, also known as pseudogout, is a disease that causes inflammatory arthropathy in peripheral joints, however, symptomatic involvement of the intervertebral disc is uncommon. Herein, we describe a 59-yr-old patient who presented with cauda equina syndrome. Magnetic resonance imaging of the patient showed an epidural mass-like lesion at the disc space of L4-L5, which was compressing the thecal sac. Biopsy of the intervertebral disc and epidural mass-like lesion was determined to be CPPD deposits. We reviewed previously reported cases of pseudogout involving the lumbar intervertebral disc and discuss the pathogenesis and treatment of the disease.
Calcium Pyrophosphate/metabolism ; Chondrocalcinosis/etiology ; Diskectomy ; Humans ; Intervertebral Disc/pathology/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Polyradiculopathy/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

Metformin which is an oral hypoglycemic agents, acts by enhancing insulin sensitivity, decreasing hepatic glucose production and increasing peripheral utilization of glucose. Deliberate self poisoning with oral hypoglycemic agents is rare. The lactic acidosis associated with metformin toxicity is well described in the medical literature. Metformin overdose even in otherwise healthy patients may produce a profound and life threatening lactic acidosis. We report a case of massive metformin ingestion(75g) in a patient presenting with lactic acidosis and hypotension. She died 24h after presenting to our emergency department despite bicarbonate treatment and hemofiltration therapy.
Acidosis ; Acidosis, Lactic ; Emergencies ; Glucose ; Hemofiltration ; Humans ; Hypoglycemic Agents ; Hypotension ; Insulin Resistance ; Metformin

PURPOSE: The purpose of this study was to analyze the colony count of airborne microbes contamination every hour in the Neurosurgical Intensive Care Unit (NSICU) in order to identify the relationship of colony count to person-visits. METHODS: Data were collected during from 11:00 a.m. September 5 to 11:00 a.m. September 6, 2002. This study used blood agar & nutrient agar and handtally counter (USA) for collection of airborne microbes and number of person-visits. Data was analyzed using the SPSSWIN 10.0 with means, Pearson correlation coefficient, and simple regression. RESULTS: The result of this study are as follows. Total colony count of airborne microbes for 24 hours in the NSICU was 4,609. Total number of person-visits to the NSICU was 15,347. The highest scores for the total colony count in different areas of the NSICU was the rear door, followed by the preparation room, and the front entrance, while the lowest count was in the isolation rooms. There was a statistically significant relationship between colony count and number of person-visits to the NSICU. The most frequently airborne microbes in the NSICU were Micrococcus, CNS, Staphylococcus Micrococcus, Aureus. CONCLUSION: These findings indicate that the number of person-visits in hospitals influences total colony count of airborne microbes. This study contributes to assessment of biological indoor air quality in hospital and in the development of an NSICU care plan.
Agar ; Air Microbiology ; Air Pollution, Indoor ; Humans ; Intensive Care Units ; Micrococcus ; Staphylococcus

Neutrophilic myositis is a very rare disease histologically characterized by neutrophil infiltration of muscle tissues. We report a case of a 47-year-old man who presented with acute onset of severe swelling and pain on his left shoulder with high fever. He was initially suspected of having cellulitis, but intravenous antibiotics did not improve his symptoms. Similar swelling and pain then developed on both calves. Investigations with magnetic resonance imaging of the lower legs and muscle biopsy led to a diagnosis of neutrophilic myositis. High dose glucocorticoid dramatically improved his symptoms within days. Clinicians need to be aware of this rare disease as a cause of acute febrile myositis mimicking infection.
Anti-Bacterial Agents ; Biopsy ; Cellulitis ; Diagnosis ; Fever ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Myositis* ; Neutrophil Infiltration ; Neutrophils* ; Rare Diseases ; Shoulder ; Sweet Syndrome

The oropharyngeal teratoma is a relatively uncommon tumors which can present as airway obstruction in neonates. We experienced a case of oropharyngeal teratoma which was attached to soft palate and combined with cleft palate and caused respiratory distress necessitated orotracheal intubation. We report the one case of oropharyngeal teratoma treated with endoscopic excision with a brief literatures.
Airway Obstruction ; Cleft Palate* ; Humans ; Infant, Newborn ; Intubation ; Palate, Soft ; Teratoma*