No abstract available.
Acute Kidney Injury*

BACKGROUND: No-reflow is a specific type of vascular damage occuring when removal of coronary occlusion dose not lead to restoration of coronary flow. There are three major explanations for the no-reflow phenomenon such as endothelial cell edema, microvascular plugging by platelets or thrombi and coronary occlusion by ischemic contracture of the myocardium. But detailed mechanisms of no-reflow phenomenon are not known. The objects of this study are to elucidate the possibility whether elevation of cytosolic Ca2+ concentration during ischemic cardioplegic period is mechanism of no-reflow phenomenon or not. METHODS: Changes in cytosolic Ca2+ concentration were measured under varying experimental condition. Free [Ca2+] in the cytosole [Ca2+]i of single rabbit coronary artery cells was measured with fluorescent Ca2+ indicator, Fura-2. RESULTS: Resting [Ca2+]i was 134.2+/-34 nM (n=43). When single cells were perfused with cardioplegic or ischemic cardioplegic solution, [Ca2+]i was significantly increased and degree of [Ca2+]i elevation was further augmented by ischemic cardioplegic solution. Pretreatment of sarcoplasmic reticulum emptying agent (20mM caffeine) had no effect on cardioplegia-induced [Ca2+]i change, but application of Ca2+ channel blocker (5x10-7M nifedipine) or an antagonist of Na+/Ca2+ exchange (5mM Ni2+ ) partially (nifedipine) or completely (nickel) inhibited the [Ca2+]i elevation. Pretreament of caffeine had no effect on ischemic cardioplegia-induced [Ca2+]i change, but application of nifedipine or nickel partially inhibited the [Ca2+]i elevation. Magnitude of ischemic cardioplegia-induced [Ca2+]i elevation was dependent on the Ca2+ concentration of perfusate from 0 to 2.5mM. When Ni2+ was added to reperfusion solution, recovery of ischemic cardioplegia-induced [Ca2+]i elevation was very rapid compared with control. CONCLUSIONS: From the above results, it may be speculated that ischemic cardioplegia-induced [Ca2+]i elevation may act as one of the mechanism of no-reflow phenomenon in rabbit coronary artery.
Caffeine ; Cardioplegic Solutions ; Coronary Occlusion ; Coronary Vessels* ; Cytosol* ; Edema ; Endothelial Cells ; Fura-2 ; Ischemic Contracture ; Muscle, Smooth* ; Myocardium ; Myocytes, Smooth Muscle* ; Nickel ; Nifedipine ; No-Reflow Phenomenon ; Reperfusion ; Sarcoplasmic Reticulum

To elucidate the possibility whether an elevation of intracellular Ca2+ concentration ([Ca2+]i) in rabbit coronary artery myocytes during ischemic cardioplegic period may serve as one of the mechanisms of the "no-reflow' phenomenon or not, the changes in [Ca2+]i were measured under ischemic cardioplegia conditions using a fluorescent Ca2+ indicator, fura 2/AM. When single cells were perfused with cardioplegic or ischemic cardioplegic solutions, [Ca2+]i was significantly increased and the degree of [Ca2+] elevation was further augmented by the ischemic cardioplegic solution. Pretreatment of a sarcoplasmic reticulum emptying agent, 20 mM caffeine, had no effect on ischemic cardioplegia-induced [Ca2+]i changes, but application of a Ca2+ channel blocker, 5 x 10 (-1)M nifedipine, or an antagonist of Na+/Ca2+ exchange, 5 mM Ni2+, significantly inhibited the [Ca2+]i elevation, respectively. The magnitude of ischemic cardioplegia-induced [Ca2+]i elevation was dependent on the Ca2+ concentration of perfusate in the range of 0 and 25 mM. When Ni2+ was added to the reperfusion solution, recovery of ischemic cardioplegia-induced [Ca2+]i elevation was very rapid compared with the controls. It is concluded that ischemic cardioplegia-induced [Ca2+]i elevation may serve as one of the mechanisms of the "no-reflow' phenomenon in rabbit coronary artery smooth muscle cells. We propose that Na+/Ca2+ exchange may serve as a key function in ischemic cardioplegia-induced [Ca2+]i elevation.
Animal ; Arteries/metabolism ; Calcium/*metabolism ; Coronary Vessels/*metabolism ; Female ; *Heart Arrest, Induced ; Intracellular Membranes/*metabolism ; Male ; Muscle, Smooth, Vascular/*metabolism/pathology ; Myocardial Ischemia/*metabolism/pathology ; Osmolar Concentration ; Rabbits ; Support, Non-U.S. Gov't

This case report describes a patient with semipedunclated granuylar cell tumor(granular cell myoblastoma) of the proximal ascending colon removed by endoscopic polypectomy. A 39-year old femalie was visited to our hospital for intermittent abdominal pain and loose stool. Colonoscopic examination showed a semipedunclated lesion covered with yellowish white smooth mucosa in the proximal ascending colon. The tumor was removed by endoscopic polypectomy. The collected specimen was 0.9x0.8 cm in size. The cut surface of the specimen showed a white round firm tumor covered with mormal epithelium of the colon. Using immunohistochemical study, the tumor cells were to be positively stained by S-100 protein and negatively stained by desmin, which supports the concept of the Schwann cell origin of granular cell tumor. In Korea, 2 cases of granular cell tumor of the colon and rectum, which were treated by surgical removal, have been reported. This case in the first endoscopic polypectomy of granular cell tumor of the colon and retum in Korea. The endoscopic polypectomy is thought to be useful for the therapy of small pedunclated or semipedunclated granular cell tumor, intracolonic type.
Abdominal Pain ; Adult ; Colon ; Colon, Ascending* ; Desmin ; Epithelium ; Granular Cell Tumor* ; Humans ; Korea ; Mucous Membrane ; Rectum ; S100 Proteins

The authors developed a computerized documentation system to record and store all the data pertaining to an endoscopic examination of the upper digestive tract. The system was programmed using the database management system Clipper Version 5.01. It is easy and convenient to use due to advanced deaign of input screen using menu bars and pull down menu and windows. The system was designed to permit the easy storage and retrieval of data by personnel who lack computer skills and who may only have limited typing ability. Today this system has been in daily use for 1 year at the endoscopic units of 8 different branch hospitals of Catholic university,medical college. Overall the experience in these centers has been positive, with excelient or good participation. Characteristics of this system are a menu-driven system, data input by predefined list, instantaneous report generation, on line access to previous examination, late entry of yathologic regerts. and record retrieval, listing according to different criteria. For the description of endoscopic findings and diagnosis, structured input is maintained. All of the findings are chosen from predefined list using pop-up screen and also free text typing is allowed. Therefore time effort was not increased compared to conventional documentation. Structured input and the resulting categorical data affer several advantages.
Database Management Systems ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal* ; Gastrointestinal Tract ; Hospitals, Satellite ; Information Systems

Bioelectrical impedance analysis (BIA) was used to determine total body water (TBW) and lean body mass (LBM) in patients with renal failure. The body's electrical resistance (R) was measured by the voltage to current ratio, injecting an 800microA alternating current with a frequency of 50KHZ and detecting a voltage drop between the wrist and the ankle. Impedance index (Height2/Resistance) compared favorably with TBW measured by deuterium (D2O) dilution method as the reference, giving the correlation coefficient (r) of 0.966 and standard error estimation (SEE) of 2.71 liter. The index was compared with LBM determined by dual-energy x-ray absorptiometry (DEXA) as the reference, giving r of 0.970 and SEE of 3.00kg. The r of 0.985 and SEE of 2.15kg were found between the reference method. BIA appeared to have a somewhat lower accuracy than those of the reference method. However, it is a useful clinical tool for estimating body composition, because it is easy, rapid and non-invasive. The existing BIA method is based on an extremely simple conductor model of the body. The accuracy may be improved further, based on a more realistic model for the body.
Absorptiometry, Photon ; Ankle ; Body Composition ; Body Water* ; Deuterium ; Electric Impedance* ; Humans ; Renal Insufficiency* ; Wrist

Duodenal tumor is relatively rare disease, accounting for about 0.3% of all carcinomas of the gastrointestinal tract. Although radiological and endoscopic examinations have become popular, we are not so familiar with the duodenal tumors as those of the other gastrointestinal tumors. The absence of precise symptoms and the rarity of primary malignant neoplasms in this localization are frequently the reason for the late diagnosis. And so, often the true nature and localization of the tumor are only determined during surgery or autopsy. But, recently, duodenal bulb is examined with ease and pathologic diagnosis is possible following the diffusion of panendoscopy. We have experienced three cases of primary duodenal bulb carcinoma, which diagnosed by biopsies with gastrofibroscopic endoscopy. So we report the cases with a brief review of literature.
Adenocarcinoma* ; Autopsy ; Biopsy ; Delayed Diagnosis ; Diagnosis ; Diffusion ; Endoscopy ; Gastrointestinal Tract ; Rare Diseases

No abstract available.
Salmonella*

Carcinosarcoma of the esophagus is regarded as a rare malignant neoplasm composed of both carcinomatous and sarcomatous elements. Esophageal carcinosarcoma classified into 3 subgroups, pseudosarcoma, so called carcinosarcoma, and true carcinosarcoma. we report a case of large polypoid tumor consist of squamous cell carcinoma, undifferentiatred small cell and spindle cell proliferation. The patient was 47 year-old man who had suffered from dysphasia and substernal chest pain for 2 months. A protruded tumor in size of 8x4x3.5 cm with stalk was found in midesophagus at the level of 28 cm from the incisor. The tumor was round with smooth surface stained with Lugol solution. There were multiple erosions at the stalk of the tumor, Partial esophagectomy and esophagogastrostomy was done, Undifferentiated small cell was confirmed by immunoreactivity to neuron specific enolase and electron microscopic findings.
Aphasia ; Carcinoma, Squamous Cell ; Carcinosarcoma* ; Cell Proliferation ; Cellular Structures* ; Chest Pain ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Humans ; Incisor ; Middle Aged ; Phosphopyruvate Hydratase

A series of 241 polyps from 127 patients endoscopically removed during the period from march 1991 through July 1992 at our department were analysed. The following items were studied. 1) Incidence, age, and sex distrlbution of the patients 2) Number of the calonic polyps 3) Histologic classification and polyp size 4) Anatomic distribution and polyp size 5) Gross types and polyp size 6) Hietopathologic types and polyp size In conclusion, colonic diminutive polyps should not be ignored or overlooked clinically. The majority were neoplastic polyps. It is suggested that diminutive polyps should be removed endoscopically if possible
Classification ; Colon* ; Colonic Polyps* ; Humans ; Incidence ; Polyps