No abstract available.
Twins, Conjoined*

No abstract available.
Thanatophoric Dysplasia*

Sarcomatoid carcinomas of the lung are rare malignant biphasic tumors composed of carcinomatous and sarcomatous components. We report a case of endobronchial sarcomatoid carcinoma in a 56-year-old man with a history of smoking, in whom the tumor was an endobronchial mass arising from the superior segmental bronchus of the left lower lobe and protruding against the main bronchus without parenchymal invasion. The patient underwent left pneumonectomy but four months later died of mesenteric sarcomatous metastasis.
Bronchi ; Humans ; Lung Neoplasms ; Lung* ; Middle Aged ; Neoplasm Metastasis ; Pneumonectomy ; Smoke ; Smoking

A double toxin-double lesion strategy is well-known to generate a rat model of striatonigral degeneration (SND) such as multiple system atrophy-parkinsonian type. However, with this model it is difficult to distinguish SND from Parkinson's disease (PD). In this study, we propose a new rat model of SND, which is generated by simultaneous injection of 6-hydroxydopamine into the medial forebrain bundle and quinolinic acid into the striatum. Stepping tests performed 30 min after intraperitoneal L-dopa administration at 6 weeks post-surgery revealed an L-dopa response in the PD group but not the SND group. Apomorphine-induced rotation tests revealed no rotational bias in the SND group, which persisted for 2 months, but contralateral rotations in the PD group. MicroPET scans revealed glucose hypometabolism and dopamine transporter impairment on the lesioned striatum in the SND group. Tyrosine hydroxylase immunostaining in the SND group revealed that 74.7% of nigral cells on the lesioned side were lost after lesion surgery. These results suggest that the proposed simultaneous double toxin-double lesion method successfully created a rat model of SND that had behavioral outcomes, multitracer microPET evaluation, and histological aspects consistent with SND pathology. This model will be useful for future study of SND.
Animals ; Apomorphine/pharmacology ; Behavior, Animal/drug effects ; Corpus Striatum/drug effects/pathology ; Disease Models, Animal ; Dopamine Plasma Membrane Transport Proteins/metabolism ; Glucose/metabolism ; Injections, Intraperitoneal ; Levodopa/pharmacology ; Male ; Medial Forebrain Bundle/drug effects/pathology ; Oxidopamine/*toxicity ; Parkinson Disease/metabolism/pathology ; Positron-Emission Tomography ; Quinolinic Acid/*toxicity ; Rats ; Rats, Wistar ; Striatonigral Degeneration/*chemically induced/metabolism/pathology ; Touch/drug effects

A 35-years-old man was hospitalized with gene-ralized edema. 6 months ago, the patient was operated by radical subtotal gastrectomy for advanced gastric adenocarcinoma. The patient presented with multiple liver metastasis and the massive proteinuria. The patients renal biopsy revealed minimal change nephrotic syndrome and treated with prednisolone and diuretics. The patient was improved clinical symptome and decreased 24 hours urine protein. In literature reviewed, gastric carcinoma was not associated with minimal change nephrotic syndrome. We experienced advanced gastric carcinoma associated with minimal change nephrotic syndrome, thus we report it.
Adenocarcinoma* ; Biopsy ; Diuretics ; Edema ; Gastrectomy ; Humans ; Liver* ; Neoplasm Metastasis* ; Nephrosis, Lipoid* ; Prednisolone ; Proteinuria

BACKGROUND: Systemic hypertension produces varying degree of LVH which is associated with increased cardiovascular morbidiity. Previous studies have documented regression of LVH with various antihypertensives including calcium channel blockers, except diuretics and vasodilators. Recently echocadiographic assessment of the change of left ventricular mass(LVM) after antihyertensive therapy have been reported to offer prognostic cardiovascular information. The aim of this echocardiographic study is determining the influence of nicardipine, a calcium channel blocker, on the change of LVM in patients with essential hypertenison. METHODS: Left ventricular mass(LVM) and left ventricular mass index(LVMI) were measured by M-mode echocardiography in 15 patients with essential hypertension. Nicardipine, a calcium channel blocker, was administered for 6 months and two echocardiographies were done before and after administering, respectively. RESULTS: In the 15 patients treated for 6 months, systolic and diastolic pressure remained very significantly decreased compared with pressure before before therapy(135+/-15mmHg vs 168+/-26mmHg, and 86+/-7mmHg vs 105+/-16mmHg, both p<0.01). Concomitantly both LVM and LVMI decreased significantly(209+/-49g vs 235+/-71g, and 116+/-6g/m2 vs 131+/-38g/m2,both p<0.05). And no change was noted in left ventricular cavity size, demonstration that LVM reduction was due to regression of hypertrophy. CONCLUSION: This study showed that nicardipine produced a significant decrease in blood pressure, LVM, and LVMI over the 6 months period. And large and longterm controlled studies are needed for the clarification of the association between nicardipine and regression of LVH in hypertensive patients.
Antihypertensive Agents ; Blood Pressure ; Calcium Channel Blockers ; Calcium Channels ; Diuretics ; Echocardiography ; Humans ; Hypertension ; Hypertrophy ; Nicardipine* ; Vasodilator Agents

Pulmonary edema is a potentially life-threatening complication of acute airway obstruction. Occasionally, patients experience sudden, unexpected and severe pulmonary edema during treatment of upper airway obstruction. Two forms of postobstructive pulmonary edema (POPE) have been identified. Type I POPE follows a sudden, severe episode of upper airway obstruction and type II POPE develops soon after the relief of chronic upper airway obstruction. The pathogenesis of POPE is multifactorial. The application of moderate continuous positive airway pressure in conjunction with the administration of diuretics usually clears pulmonary edema in these clinical settings within 24 hours. Awareness of this uncommon condition is crucial for the otolaryngologist to make an early diagnosis and initiate successful treatment. We present two cases of postobstructive pulmonary edema after treatment for upper airway obstruction.
Airway Obstruction ; Continuous Positive Airway Pressure ; Diuretics ; Early Diagnosis ; Humans ; Pulmonary Edema*

Excessive influx and the subsequent rapid cytosolic elevation of Ca²⁺ in neurons is the major cause to induce hyperexcitability and irreversible cell damage although it is an essential ion for cellular signalings. Therefore, most neurons exhibit several cellular mechanisms to homeostatically regulate cytosolic Ca²⁺ level in normal as well as pathological conditions. Delayed rectifier K⁺ channels (I(DR) channels) play a role to suppress membrane excitability by inducing K⁺ outflow in various conditions, indicating their potential role in preventing pathogenic conditions and cell damage under Ca²⁺-mediated excitotoxic conditions. In the present study, we electrophysiologically evaluated the response of IDR channels to hyperexcitable conditions induced by high Ca²⁺ pretreatment (3.6 mM, for 24 hours) in cultured hippocampal neurons. In results, high Ca²⁺-treatment significantly increased the amplitude of IDR without changes of gating kinetics. Nimodipine but not APV blocked Ca²⁺-induced IDR enhancement, confirming that the change of I(DR) might be targeted by Ca²⁺ influx through voltage-dependent Ca²⁺ channels (VDCCs) rather than NMDA receptors (NMDARs). The VDCC-mediated I(DR) enhancement was not affected by either Ca²⁺-induced Ca²⁺ release (CICR) or small conductance Ca²⁺-activated K⁺ channels (SK channels). Furthermore, PP2 but not H89 completely abolished I(DR) enhancement under high Ca²⁺ condition, indicating that the activation of Src family tyrosine kinases (SFKs) is required for Ca²⁺-mediated I(DR) enhancement. Thus, SFKs may be sensitive to excessive Ca²⁺ influx through VDCCs and enhance I(DR) to activate a neuroprotective mechanism against Ca²⁺-mediated hyperexcitability in neurons.
Animals ; Calcium Channels ; Cytosol ; Humans ; Kinetics ; Membranes ; Neurons* ; Nimodipine ; Protein-Tyrosine Kinases* ; Rats* ; Receptors, N-Methyl-D-Aspartate ; src-Family Kinases ; Tyrosine*

Fungal peritonitis is one of the leading causes of patient dropout from continuous ambulatory peritoneal dialysis (CAPD) therapy. Although the most causative agents of peritonitis associated with CAPD are bacteria, fungi are implicated in up to 10% of cases. The most common organism of fungal peritonitis is Candida specises, but Trichosporon beigelii was reported as a rare causative agent of fungal peritonitis. We experienced a case of CAPD peritonitis by Trichosporon beigelii, which was treated with CAPD catheter removal, and antifungal agents with amphotericin B and fluconazole. Thus, we report our experience of CAPD peritonitis caused by Trichosporon beigelii and review of the literature.
Amphotericin B ; Antifungal Agents ; Bacteria ; Candida ; Catheters ; Fluconazole ; Fungi ; Humans ; Patient Dropouts ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Trichosporon*

PURPOSE: To outline the aspects of extubation by birth weight and find the predictors for success/ failure at the first extubation in extremely low birth weight infants. METHODS: One hundred thirteen extremely low birth weight infants(< 1,000 g) who were admitted to NICU at Samsung Seoul Hospital between Jan. 2000 and Jun. 2004 were enrolled. Clinical characteristics that are thought to be related with extubation success or failure were compared with the success and the failure of the first extubation. RESULTS: As the birth weight decreased, extubation success day was significantly delayed:16+/-3 day(d) in 900-999 g; 20+/-3 d in 800-899 g; 35+/-4 d in 700-799 g; 37+/-9 d in 600-699 g; 49+/-12 d in < or =599 g. 25 out of 113 infants(22%) failed the first extubation. Preterm premature rupture of membrane was associated with extubation success, and air leak was associated with extubation failure, with a borderline significance. Postnatal and corrected age and body weight at the first extubation, nutritional status, and ventilator settings were not associated with extubation success or failure. Extubation success day was significantly delayed, and the incidence of late-onset sepsis and mortality was significant higher in the failure of the first extubation. CONCLUSION: We could not find significant predictors for success/failure at the first extubation. The failure of the first extubation had an increased risk of late-onset sepsis and death. Further studies are needed to find the predictors for extubation success/failure.
Birth Weight* ; Body Weight ; Humans ; Incidence ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Membranes ; Mortality ; Nutritional Status ; Parturition* ; Rupture ; Seoul ; Sepsis ; Ventilators, Mechanical