Measurement of the evoked action potential in muscle as an adjunctive to the clinical evaluation of peripheral nerve lesion resulted in the more frequent use of compound muscle action potential to evaluate peripheral nerve problems. Recently, the intraoperative use of nerve stimulation and recording technique have made it possible to evaluate the peripheral nerve problems intraoperatively. The present study was, therefore, undertaken to address this question in rabbit sciatic nerves and to determine intraoperative stimulation and recording technique are practical in clinical situations. A low-heat injury to the sciatic nerve was induced by perfusing 60degrees C saline around the nerve for 30 minutes and followed the courses of functional and morphological recovery of the nerve for 16 weeks. The results are ,summarized as follows ; In the test of compound muscle action potential(CMAP), the average amplitude and the onset latency were markedly attenuated at 4 and 8 week after the low-heat treatment (1.2mV, 4.2mV)(3.58msec, 2.68msec)(p=0.045, p=0.039). It progressively reverted to tile control level, showing 0.63 msec at 16 weeks. In the test of intraoperative nerve action potential(INAP), the average amplitude and the onset latency were attenuated at 4 and 8 weeks after the low-heat treatment(1.8mV, 2.1 mV)(1.18msec, 1.05msec)(p=0.041, p=0.043). There existed a significant positive correlation between the amplitude and onset latencies of INAP and CMAP measured in Low-heat group(r=0.67, r=0.71, p=0.003, p=0.009). Similar pattern of amplitude and onset latency between tests of CMAP and INAP suggests that INAP was practical and useful.
Action Potentials* ; Nerve Regeneration ; Pasteurization ; Peripheral Nerves ; Regeneration* ; Sciatic Nerve*

No abstract available.
Shoulder*

In situ extracorporeal shock wave lithotripsy(ESWL) monotherapy was performed in 75 cases with ureteral stones using the Modulith SL 20 electromagnetic lithotriptor between December 1990 and July 1991. The results obtained were as follows: 1. The locations of stones were upper ureter in 36 (48%) cases, midureter in 4 (5.3%) and lower ureter in 35 (46.7%). 2. The average number of ESWL was 1.27 sessions. 3. The number of ESWL sessions increased in accordance with increment of stone size. 4. The success rate was 97.2% in upper ureteral. 100% in midureteral, and 97.1% in lower ureteral stones. 5. The final success rate according to stone size was not significantly different. 6. Success rate decreased relatively in cases of complete ureteral obstruction by stones. Therefore, in situ ESWL monotherapy is considered to be a convenient safe, and efficient procedure as the first applicable method for the treatment of all ureteral stones regardless of stone size and location, because the multiple repeated ESWL monotherapy increases the success rate without ureteral deterioration.
Magnets ; Shock ; Ureter* ; Ureteral Obstruction

PURPOSE: Many of the enzymes handling environmental factors are polymorphic and may confer variable susceptibility to renal cell carcinoma (RCC). Among those, the author studied genetic polymorphisms of CYP2D6 (B & T) and CYP1A1 in RCCs and controls in Korean. MATERIALS AND METHODS: Using 132 RCCs and 94 controls, first PCR products were obtained in 104 RCCs and 94 controls with CYP2D6, and 74 RCCs and 56 controls with CYP1A1. Res triction enzyme - BstN I/EcoN I for CYP2D6 (B & T), and NCo I for CYP1A1-digestion was followed to analyze constitutive DNA. RESULTS: In both RCCs and controls, no mutant allele of CYP2D6 (B & T) was detected and the susceptibility for occurrence of RCC was unable to evaluate. With CYP1A1 RFLP, homozy gous wild type (WW) was seen in 68 (52.3%; 37 RCCs, 31 controls), heterozygous mutant type (WM) in 54 (41.5%; 32 RCCs, 22 controls) and homozygous mutant type (MM) in 8 (6.2%; 5 RCCs, 3 controls). The odds ratios (95% CI) of RCC susceptibility for CYP1A1 genotype were 1.15 for WM and 1.36 for MM. Even though not significant statistically, higher tendency in MM presented. CONCLUSION: There is no association between susceptibility for the occurrence of RCC and genetic polymorphism of CYP2D6 (B & T) and CYP1A1.
Alleles ; Carcinoma, Renal Cell* ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 CYP2D6* ; DNA ; Genotype ; Odds Ratio ; Polymerase Chain Reaction ; Polymorphism, Genetic* ; Polymorphism, Restriction Fragment Length

Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.
Adult ; Deglutition Disorders ; Drug Therapy ; Esophageal Stenosis* ; Esophagectomy ; Esophagitis ; Esophagitis, Peptic ; Fibrosis ; Humans ; Induction Chemotherapy* ; Leukemia ; Leukemia, Myeloid, Acute

PURPOSE: We wanted to evaluate the usefulness of dynamic magnetic resonance (MR) imaging for differentiating between benign and malignant solitary pulmonary nodules (SPNs). MATERIALS AND METHODS: Sixteen patients who had an undetermined SPN (<15 mm) upon chest computed tomography (8 males and 8 females; mean age: 55 years; age range: 40-76 years) underwent dynamic MR imaging. After the bolus injection of contrast material, the arterial (20-35 seconds), portal (45-60 seconds) and equilibrium (3-5 minutes) phase T1-weighted axial images were obtained with using a volumetric interpolated breath-hold examination. For discriminating the benign from malignant SPNs, the maximum relative enhancement ratio (MER) and the slope of the enhancement (SLE) were calculated and then they were statistically compared. With varying the threshold of the two indexes, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. RESULTS: The mean MER of the malignant SPN group was significantly higher than that of the benign SPN group (malignant; 0.56+/-0.17, benign; 0.43+/-0.17). With 0.33 as the threshold of MER for distinguishing the malignant SPN group from the benign SPN group, the sensitivity, specificity, positive predictive value and negative predictive value were 100%, 70%, 50%, and 100%, respectively. The mean SLE for the benign SPN group was higher than that for the malignant SPN group (malignant; m= 0.008+/-0.006/sec, benign; m=0.013+/-0.008/sec). With 0.025 as the threshold of the SLE, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 100%, 60%, 62.5%, 100% and 69.2%, respectively. CONCLUSION: Dynamic MRI was useful for differentiating between benign and malignant SPNs. Moreover, MER and SLE might be good indexes for distinguishing benign SPNs from malignant SPNs.
Female ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging* ; Male ; Sensitivity and Specificity ; Solitary Pulmonary Nodule* ; Thorax

PURPOSE: The aim of this study is to evaluate the value of pleural adenosine deaminase (ADA) in differentiating tuberculous pleural effusion from non tuberculous pleural effusion of children. METHODS: We measured pleural ADA activity in patients with pleural effusion whose age were from seven months to seventeen years from January 1995 to October 2001. By some criteria the patients were grouped to tuberculous pleural effusion, bacterial effusion, mycoplasma effusion, malignant effusion, and other effusion. RESULTS: The mean pleural ADA activity in tuberculous pleural effusion was 86.2+/-27.3 U/L. Pleural ADA activities in bacterial effusion, mycoplasma effusion, malignant effusion, other effusion were 32.6+/-20.1, 22.1+/-15.4, 23.1+/-10.9, 36.7+/-28.4 U/L, respectively. Pleural ADA activity in tuberculous pleural effusion was significantly higher than in any other group(P<0.001). At a level of 50 U/L, the sensitivity, specificity, positive predictive value (ppv), and and negative predictive value(npv) for the identification of tuberculous pleural effusion from nontuberculous pleural effusion were calculated at 93.8%, 84.8%, 81.1%, 95.1%, respectively. CONCLUSION: Pleural ADA is a useful test in the diagnosis of tuberculous pleural effusion of children from nontuberculous pleural effusion.
Adenosine Deaminase* ; Adenosine* ; Child* ; Diagnosis* ; Humans ; Mycoplasma ; Pleural Effusion* ; Sensitivity and Specificity

OBJECTIVES: Apoptosis is a process of active cell death, distinct from necrosis and characterized by specific morphological and biochemical features. Apoptosis induced by metals and metal-related deleterious conditions has only recently been studied. Although the toxic effects of heavy metals are well described, little is known about the mechanism of apoptosis via cadmium toxicity. Therefore, this study is designed to define the induction mechanism of apoptosis by which cadmium exerts its cytotoxic effect on human promyelocytic leukemic HL-60 cells. The cytotoxic effects of cadmium on HL-60 cells are studied in regards to apoptotic signal transduction pathways. METHODS: The mode of cadmium-induced apoptosis was investigated in HL-60 cells. HL-60 cells were treated with various concentrations of cadmium and antioxidants after which the viability of the cells were measured by MTT assay. The morphological features of cadmium- induced apoptosis were evaluated by fluoromicroscopy and the DNA fragmentation was analyzed using 1.5% agarose gel electrophorosis. Kinase activity was assayed by autoradiography and activity of NF-kappaB and nuclear proteins were measured by EMSA. RESULTS: Cadmium (125 microM) induces the characteristic morphological features of apoptosis, which are characterized by a shrinkage of the cytoplasm and a condensation of chromatin. In addition, cadmium induced the ladder pattern of DNA fragmentation. Antioxidants(Sodium nitroprusside, glutathione and N-acethylcysteine), which were not toxic to the cells, did not suppress apoptosis induced by cadmium. Cadmium enhances the expression of several classes of genes at elevated cytotoxic concentrations. Poly(ADP-ribose) polymerase(PARP) was predominantly in the fragmented form when doses of 125 microM were used. Since PARP is cleaved by CPP32 (caspase-3), we next determined if cadmium was capable of effecting changes in CPP32 activity. The results of these experiments showed that cadmium increased caspase-3 activity in a time dependent manner, corresponding to the time of appearance of fragmented PARP. Cadmium also increased the phosphotransferase activities of c-JUN N-terminal kinase (JNK). Furthermore, cadmium increased the activation of transcriptional factors including the activation of protein-1 (AP-1) and NF-kappaB . CONCLUSIONS: These results suggest that cadmium induces the apoptotic death of HL-60 cells via the activation of a DEVD-specific caspase, JNK and transcriptional factors such as AP-1 and NF-kappaB .
Antioxidants ; Apoptosis* ; Autoradiography ; Cadmium ; Caspase 3 ; Cell Death ; Chromatin ; Cytoplasm ; DNA Fragmentation ; Glutathione ; HL-60 Cells* ; Humans ; JNK Mitogen-Activated Protein Kinases ; Metals ; Metals, Heavy ; Necrosis ; NF-kappa B ; Nitroprusside ; Nuclear Proteins ; Phosphotransferases ; Poly Adenosine Diphosphate Ribose ; Sepharose ; Signal Transduction* ; Transcription Factor AP-1

The incidence of glomerulonephritis associated with malignancy is not common. Membranous glomerulonephritis associated with carcinomas and minimal change nephrotic syndrome with Hodgkin's disease has been occasionally reported. The pathogenesis of glomerular injury associated with malignancy is not well known. The IgA nephropathy associated with malignancy, though rare, has been reported. IgA nephropathy associated with acute myeloid leukemia, however, is yet to be reported. We hereby report a case of IgA nephropathy associated with acute myeloid leukemia (AML M2).
Incidence

The incidence of glomerulonephritis associated with malignancy is not common. Membranous glomerulonephritis associated with carcinomas and minimal change nephrotic syndrome with Hodgkin's disease has been occasionally reported. The pathogenesis of glomerular injury associated with malignancy is not well known. The IgA nephropathy associated with malignancy, though rare, has been reported. IgA nephropathy associated with acute myeloid leukemia, however, is yet to be reported. We hereby report a case of IgA nephropathy associated with acute myeloid leukemia (AML M2).
Incidence