No abstract available.
Amniotic Band Syndrome* ; Infant, Newborn

BACKGROUND: Tumor necrosis factor(TNF)-alpha and Interleukin(IL)-1beta are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-alpha in the pathogenesis of ARDS, including human studies, it has been reported that TNF-alpha is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-alpha and IL-lbeta as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. METHODS: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood sample were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-alpha and IL-lbeta was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. RESULTS: 1) Plama TNF-alpha levels: Plasma TNF-beta levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the mean+/-2SD, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-alpha levels from patients with ARDS were 10.26pg/mL(median;<10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-alpha levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (P<0.01). There was no statistical significance between survivors(< 10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-alpha levels. 2) Plasma IL-lbeta levels: Plasma IL-1beta levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-1beta levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ng/mL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-19 levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). CONCLUSION: Plasma TNF-alpha and IL-1beta level are not a predictable marker for development of ARDS. But TNF-alpha is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-alpha and IL-1beta in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.
Acute Lung Injury ; Adult* ; Chungcheongnam-do ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intensive Care Units ; Interleukin-1beta* ; Lung ; Lymphotoxin-alpha ; Necrosis ; Plasma ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Shock ; Shock, Septic ; Tumor Necrosis Factor-alpha*

We experienced a case of submucosal gastric actinomycosis, presenting as bleeding. The 65-year-old woman had a symptom of epigastric pain, without any other intra-abdominal disease entity. A gastrofiberscopic study demonstrated a submucosal mass lesion with bleeding at the fundus. Because of the bleeding, laparotomy was undertaken, and a abscess containing a large mass was found at the gastric fundus, and total gastrectomy undertaken. Histological examination revealed a giant acute ulcer with a submucosal abscess due to actinomycosis. Because of its rarity, submucosal gastric actinomycosis is an entity overlooked by most surgeons. We report upon this case of submucosal gastric actinomycosis and include a review of the literature.
Female ; Humans

No abstract available.
Female ; Ovary* ; Teratoma*

No abstract available.
Leiomyoma* ; Vagina*

Degenerative disc disease has traditionally been thought of as low back pain caused by changes in the nucleus pulposus and annulus fibrous, in recent studies, however, changes in the upper and lower endplates cause degeneration of the disc, resulting in mechanical pressure, inflammatory reactions and low back pain. Recently, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous were considered as a single unit, and the relationship was explained. Once the endplate is damaged, it eventually aggravates the degeneration of the bone marrow, nucleus pulposus, and annulus fibrosus. In this process, the compression force of the annulus fibrosus increases, and an inflammatory reaction occurs due to inflammatory mediators. Hence, the sinuvertebral nerves and the basivertebral nerves are stimulated to cause back pain. If these changes become chronic, degenerative changes such as Modic changes occur in the bone marrow in the vertebrae. Finally, in the case of degenerative intervertebral disc disease, the bone marrow of the vertebral body-endplate-nucleus pulposus and annulus fibrous need to be considered as a single unit. Therefore, when treating patients with chronic low back pain, it is necessary to consider the changes in the nucleus pulposus and annulus fibrosus and a lesion of the endplate.

BACKGROUND: Under certain conditions, exertional headaches may reflect coronary ischemia. CASE REPORT: A 44-year-old woman developed intermittent exercise-induced headaches with chest tightness over a period of 10 months. Cardiac catheterization followed by acetylcholine provocation demonstrated a right coronary artery spasm with chest tightness, headache, and ischemic effect of continuous electrocardiography changes. The patient's headache disappeared following intra-arterial nitroglycerine injection. CONCLUSIONS: A coronary angiogram with provocation study revealed variant angina and cardiac cephalalgia, as per the International Classification of Headache Disorders (code 10.6). We report herein a patient with cardiac cephalalgia that manifested as reversible coronary vasospasm following an acetylcholine provocation test.
Acetylcholine ; Adult ; Angina Pectoris ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vasospasm ; Coronary Vessels ; Electrocardiography ; Female ; Headache ; Headache Disorders ; Humans ; Ischemia ; Nitroglycerin ; Spasm ; Thorax

Cancer may be a disease of genes, arising from genetic damage of diverse sorts-recessive and dominant mutations, large rearrangement of DNA and gene translocation on chromosomes, all leading to distorisions of either the expression or biochemical function of genes. The search for these genetic damage in neoplastic cells now is the most important in cancer research. It has been found that the cancer relevant genes were located on the specific regions of chromosomes. To determine whether epidermal growth factor receptor(EGFR), P53 and bcr genes located in chromosomes 7, 17 and 22 are altered, we examined 12 neuroepithelial tumor with Southern blot analysis(five low grade astrocytoma, two high grade astrocytoma, two medulloblastoma, on oligodendroglioma, one ependymoma, one choroid plexus papilloma). The loss of heterozygosity(LOH) of EGFR gene was detected in two cases of medulloblastoma. The rearrangement of EGFR gene was detected in a case of ependymoma. The LOH of P53 gene was found in a case of choroid plexus papilloma and low grade astrocytoma. The rearrangement of P53 gene was founs id a case of oligodendroglioma. The LOH of bcr gene was observed in two cases of medulloblastoma and low grade astrocytoma. The rearrangement of bcr gene was observed in two cases of high grade astrocytoma. These results suggested that tumorigenesis and tumor development in the neuroepithelial tumor may invlove specific gene changes in chromosomes 7, 17 and 22.
Astrocytoma ; Blotting, Southern ; Carcinogenesis ; Choroid Plexus ; DNA ; Ependymoma ; Epidermal Growth Factor ; Genes, erbB-1 ; Genes, p53 ; Loss of Heterozygosity ; Medulloblastoma ; Neoplasms, Neuroepithelial* ; Oligodendroglioma ; Papilloma, Choroid Plexus

Uterine rupture is the important cause of life threatening to mother and fetus, in spite of progressed obstetrics. We must observe the patient carefully before labor, during labor and after delivery for the higher prediction of uterine rupture. We experienced a case of incomplete uterine rupture at 40 weeks of gestation weeks in a 37-year-old multigravida tried vaginal birth after cesarean delivery. So we present it with brief review of literatures.
Adult ; Fetus ; Humans ; Mothers ; Obstetrics ; Pregnancy ; Uterine Rupture* ; Vaginal Birth after Cesarean*

The clinical and pathological features were analyzed for 11 cases with intracranial ependymoma treated surgically at the Keimyung University Dongsan Medical Center during the years 1987 to 1992. Tumor histology was reviewed individually and grouped into three categories(Categories I to III) according to the pathologic grade used by Nazar, et al. There were 2 cases(18%) with category I histology, 5(45%) with category II histology, and 4(36%) with category III histology. The high recurrent rate, short recurrent interval, high rate of cerebrospinal fluid seeding and poor outcome were noted in patients with category III histology. The authors also investigated the recurrent interval according to the degree of tumor resection. The mean recurrent interval after surgery was 12 months in cases of subtotal resection and 33 months in a case of total resection. Tumors resected subtotally showed response to radiation and chemotherapy. In conclusion, the pathologic grade and the degree of tumor resection were regarded as important prognostic factors after surgery. Aggressive surgery with chemotherapy or radiotherapy were required in the management of intracranial ependymoma.
Cerebrospinal Fluid ; Drug Therapy ; Ependymoma* ; Humans ; Prognosis ; Radiotherapy