BACKGROUND: When used to reverse the anticoagulant effect of heparin, protamine administration after cardiovascular bypass often can lead to systemic hypotension. During the reversal of heparin-induced anticoagulation, the effects of protamine on both a heparin-protamine complex and free protamine on the cardiovascular system should be considered. METHOD: To determine whether the hypotensive effect of heparin-protamine and/or protamine could be caused by endothelium-dependent and-independent component, we studied rings of the arotic arteries in rats suspended in organ chambers containing Tris Tyrode solution at 37oC and 100% O2. Arterial rings with or without endothelium were contracted with 40 mM KCl or 3 +/- 10-6M phenylephrine and then exposed to increasing concentrations of protamine (final organ bath concentration, 40~400 g/ml) both in the absence and presence of heparin (200 U/ml). RESULTS: Protamine induced concentration-dependent relaxation in arterial rings with endothelium, which were significantly greater than in rings without endothelium. The endothelium-dependent relaxation induced by protamine was inhibited by NG-monomethyl-L-arginine (L-NMMA) (10-5M) pretreatment, but was not inhibited by indomethacin (3x10-6M) pretreatment on rings with endothelium. Furthermore, the contractile inhibition was enhanced by superoxide dismutase (100 U/ml). Also, such vasodilating actions were not influenced in the presence of heparin (200 U/ml). In endothelium-denuded strips, protamine (400ug/ml) inhibited Ca++ induced contraction, which was evoked in Ca++-free solution containing 40 mM K+, and also inhibited the norepinephrine (NE)-induced contraction. Protamine inhibited on the NE-induced contraction, but not the caffein-induced contration in Ca++ free, 2 mM EGTA solution. Also, such inhibition of contracions were not inluenced in the presence of heparin (40 U/ml). CONCLUSION: This study demonstrates that protamine (in the presence or absence of heparin) acts on endothelial cell receptors to stimulate the production of nitric oxide and inhibits both Ca++-influx and the NE-induced Ca++ release from intracellular stores.
Animals ; Arteries* ; Baths ; Cardiovascular System ; Egtazic Acid ; Endothelial Cells ; Endothelium ; Heparin* ; Hypotension ; Indomethacin ; Nitric Oxide ; Norepinephrine ; omega-N-Methylarginine ; Phenylephrine ; Rats* ; Relaxation ; Superoxide Dismutase ; Vasodilation*

No abstract available.
Carcinoma, Non-Small-Cell Lung* ; Drug Therapy, Combination*

No abstract available.
Diagnosis* ; DNA* ; Polymerase Chain Reaction* ; Tuberculosis*

BACKGROUND: Anaphylaxis is a systematic allergic reaction, which may be fatal. However, despite its seriousness, its low level of incidence has prevented in depth studies. Thus, we analyzed the causes of anaphylactic shock in patients admitted in a tertiary hospital, observed its clinical symptoms, and formed a basis for adequate emergency treatment, as well preventive methods. METHODS: The patients who visited Ajou university hospitals from June 1994 to May 2000(7 years) and who met the 1974 JAMA definition were selected for this retrospective study. The analysis of causative agents was made on the basis of clinical symptoms and the patients' chief complaints at the time of admission. Patients diagnosed with anaphylactic shock included those showing at least two types of IgEmediated symptoms; and those with a simple rash or breathing difficulties were excluded from the study. RESULTS: Of 36 patients, 22 were male and 14 female, Those below the age of 20 comprised 16.7% of the patients(6 patients), between 20 and 29 comprised 16.7%(6 patients), 30 and 39 comprised 25%(9 patients), 40 and 49 comprised 27.8%(10 patients), over 50 comprised 14%(5 patients). The overall percentage show 70% of the patients in active adult age group. Rash was the most common clinical symptoms(89%, 32 patients) and hypotension the second(75%, 27 patients), followed by respiratory distress, fainting, and arrhythmia. Causative agents were insect bites, including bee stings(15 patients), medication(12 patients), food(8 patients), and unknown(1 patients). Nine(9) of the 36 case, were diagnosed as having an atopic origin. CONCLUSION: Bee sting was the single most common cause in the insect criteria while penicillin and NSAIDs accounted for most of medication-induced cases. Food showed a varied distribution. An atopic origin was not a basis for anaphylactic shock, but did show a two-fold increase of prevalence. This study is the first of its kind in addressing anaphylactic shock, a potentially severe illness, over a period of 7 years.
Adult ; Anaphylaxis* ; Anti-Inflammatory Agents, Non-Steroidal ; Arrhythmias, Cardiac ; Bees ; Bites and Stings ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Exanthema ; Female ; Hospitals, University ; Humans ; Hypersensitivity ; Hypotension ; Incidence ; Insect Bites and Stings ; Insects ; Male ; Penicillins ; Prevalence ; Respiration ; Retrospective Studies ; Syncope ; Tertiary Care Centers*

No abstract available.
Lung Neoplasms* ; Lung*

PURPOSE: Minocycline appears to reduce the mortality rate of patients with myocardial infarction. Therefore, the cardioprotective effects of minocycline through reduction of apoptosis were studied in a rat myocardiac cell culture induced by hypoxia. METHODS: Cultured cells from the hearts of Sprague-Dawley rats were divided into two sets of groups: normoxia groups treated with 5% O2 and hypoxia groups treated with 1% O2. After several days of incubation, the control groups were not treated with minocycline, while the sample groups were treated with 1 mug/mL of minocycline. The damaged cells were observed under a microscope, while apoptosis was detected using a Tdt-mediated dUTP nick and labeling(TUNEL) assay control-stained with 4'-6'-diamidino-2-phenylindole-2HCl(DAPI). RESULTS: In normoxia, the control group showed a statistically significant difference from the sample group treated with 1 mug/mL of minocycline. In addition, in hypoxia, there was also a statistically significant difference between the two groups. When comparing the normoxia and hypoxia groups to each other, there was a statistically significant difference between the control groups and sample groups. CONCLUSION: Minocycline was found to be protective for heart in normoxia and in hypoxia in the model of rat myocardiac cell culture.
Animals ; Anoxia* ; Apoptosis ; Cell Culture Techniques* ; Cells, Cultured ; Heart ; Humans ; Minocycline* ; Mortality ; Myocardial Infarction ; Rats* ; Rats, Sprague-Dawley

OBJECTIVE: This present study was conducted to examine the effects on in vitro growth of pre-antral mouse follicles by thecal-stromal cells attached to around the follicular membrane in culture medium without hormones. METHODS: Pre-antral follicles (100-130 micro meter) used in our studies were isolated mechanically by fine 30 G needles attached to 1 ml insulin syringe from mice ovaries of 20-25 days old female ICR strain. Isolated pre-antral follicles were divided into three groups by attached status of thecal-stromal cell layers to follicular membrane. Follicular Initial diameters of group I was 112.5 (mean) +/- 6.2 (SD) micro meter (n=31), group II was 112.8 +/- 7.8 micro meter (n=23), and group III was 115.1 +/- 6.5 micro meter (n=27). Divided pre-antral follicles were washed in fresh Ham's F-10 medium and cultured in 20 micro liter droplets of DMEM with glutamine, glucose and pyruvate under mineral oil on the 60 mm culture dish. All experimental media were supplemented with 10% FBS without hormones. Media were exchanged wholly by fresh media every 2 days in culture. Diameters of intrafollicular oocytes and cultured pre-antral follicles were measured using an precalibrated cross ocular micrometer at X200 every day during 6 days in vitro culture. Results were considered statistically significant when p value was less than 0.05 using Student's t-test. RESULTS: The mean and standard deviation (SD) of initial diameters of pre-antral follicles was 113.5 +/- 2.2 micro meter in three groups. Follicular growth rate of group III was significantly (p<0.05) higher in whole culture periods than group I and group II. Rate of follicular growth between group I and group II were not significant difference in culture for 1 to 3 days. However, group II was significantly higher than group I in culture for 4 days. Diameters of grown follicles for 6 days was 155.2 +/- 18.7 micro meter, 196.9 +/- 24.1 micro meter and 284.2 +/- 47.6 micro meter in group I, group II and group III, respectively. Growth rate of intrafollicular oocytes between three groups were not difference and revealed to continuous growth patterns in whole culture periods. Follicular diameter after culture for 7 days were not measured because of disruption of follicular structure or outgrowth of granulosa cells. CONCLUSION: Pre-antral follicles were grown very well in DMEM medium without hormones. Thecal- stromal cells attached to the surface of follicular membrane has acted effectively in vitro growth of follicles.
Animals ; Female ; Glucose ; Glutamine ; Granulosa Cells ; Humans ; Insulin ; Membranes ; Mice* ; Mineral Oil ; Needles ; Oocytes ; Ovary ; Pyruvic Acid ; Stromal Cells ; Syringes

Although primary hyperparathyroidism is a rare disease in Korea, the incidence is increasing gradually due to increased concern and the development of laboratory and imaging techniques. Previous radiological imaging studies for localization of a parathyroid adenoma have been generally unreliable. Recently, preoperative administration of Tc-99m sestamibi has improved detection of parathyroid adenomas. Combining preoperative administration of the sestamibi radionuclide with an intraoperative gamma probe can identify the exact location of a parathyroid adenoma successfully and facilitate a safe and efficient operation under local anesthesia. Limited exploration provides a better cosmetic result while decreasing the potential complications of bilateral exploration. Also, an obvious indication for radio-guided para thyroid surgery with a minimal approach may well be the high-risk patient who cannot tolerate a general anesthestic or an extensive surgical approach. We report three cases of primary hyperparathyroidism which were successfully treated with intraoperative radio-guided parathyroid surgery. These parathyroid surgery can be enhanced especially in the future, when and if an efficient and cost-effective intraoperative PTH assay becomes available.
Anesthesia, Local ; Humans ; Hyperparathyroidism, Primary* ; Incidence ; Korea ; Parathyroid Neoplasms ; Parathyroidectomy* ; Rare Diseases ; Thyroid Gland

PURPOSE: The residual microscopic carcinoma after breast conserving surgery is the most important risk factor of local recurrence. As local recurrences usually develop around resected margins, it is ge nerally accepted that every effort should be made to achieve negative margins intraoperatively, and the presence of microscopically positive margins requires reexcision. Interestingly, sizable percentage of reexcisions results in a specimen free of residual tumor, and may not contribute to disease control, but do add morbidity, cost, and possibly compromise cosmetic result. The goal of our study was to identify which clinico-pathologic factors were associated with positive resection margin, and to identify the variables associated with no residual carcinoma on reexcision or total mastectomy specimens. METHODS: From Sepember 1994 to July 1999, 322 breast conserving surgery were performed on breast cancer patients at the Department of General Surgery, Samsung Medical Center. Among them, 13 patients had positive surgical margins and were treated with reexcision (reexcising the previous lumpectomy cavity with a margin of 1-2 cm of normal tissue) or total mastectomy. RESULTS: The factors associated with positive resection margins were large tumor size, the presence of extensive intraductal component (EIC), and suspicious mammographic microcalcifications without mass density. Six (46.3%) of these reoperation cases for positive margins were negative for residual tumor. The factors correlating with no residual carcinoma on reexcision or mastectomy specimens were small histologic primary tumor size and only one positive resection margin rather than 2 or more positive margins. CONCLUSION: The patients with above-mentioned factors associated with positive resection margins should be treated with more wide local excision or total mastectomy to avoid a second surgical procedure. If the patients with only one positive margin and small tumor size refuse second operation, they could be treated with irradiation only sparing an additional surgical procedure.
Breast Neoplasms ; Breast* ; Humans ; Mastectomy ; Mastectomy, Segmental* ; Mastectomy, Simple ; Neoplasm, Residual ; Recurrence ; Reoperation* ; Risk Factors

BACKGROUND: The accurate staging of patients with breast cancer is essential to its management and prognosis. Sentinel node biopsy appears to offer an alternative to routine axillary lymph node dissection for staging breast cancer patients. Current method of routine histopathologic analysis of dissected lymph nodes may be inadequate because up to 30% of patients free of lymph node metastases develop a relapse in 5 to 10 years. Recently, the development of amplification of MUC1 mRNA and keratin 19 mRNA by RT-PCR for detection of micrometastases in breast cancer has been shown to be a sensitive and useful diagnostic method. This study was performed to evaluate the usefulness of MUC1 mRNA and keratin 19 mRNA markers by RT-PCR to detect micrometastases in frozen sections of sentinel lymph nodes from breast cancer patients and to identify which histopathologic prognostic factors were related to RT-PCR detected micrometastases. METHODS: The incidence of axillary micrometastases in 15 sentinel lymph node specimens from 15 patients who underwent breast cancer surgery with sentinel lymphadenectomy was from June 1999 to July 1999 was studied. Complete axillary dissection was made in all of the patients. Each sentinel lymph node specimen was examined by hematoxylin and eosin (H&E) staining, immunohistochemical cyto keratin (IHC) staining and RT-PCR on adjacent sections to determine the expression of the mRNA tumor marker of MUC1 and keratin 19. All of the dissected lymph nodes were examined by serial sectioning. RESULTS: Fourteen out of 15 sentinel lymph nodes were histologically negative in usual H&E staining. Serial sectioning, immunohistochemical (IHC) staining for cytokeratin demonstrated micrometastases in one, two histologically negative sentinel nodes, respectively, and MUC1 mRNA was detected in all of them. Of the 12 sentinel lymph nodes that were diagnosed to be devoid of micrometastases by IHCand serial sectioning, MUC1 mRNA was expressed in 6 nodes, indicating the presence of micrometastases. Micrometastases detected by RT-PCR were significantly correlated with tumor size, expression of p53 and negative PR in conventionally lymph node-negative staged patients. CONCLUSION: The MUC1 mRNA RT-PCR was more sensitive than immunohistochemistry and serial sectioning for the detection of micrometastases in axillary lymph nodes, but keratin 19 was not specific. Sentinel lymph node biopsy with RT-PCR is a more useful means of detecting micrometastases and may have a role in identifying a group of patients who will benefit from earlier adjuvant chemotherapy, but the prognostic significance must be determined after a longer follow-up.
Biopsy ; Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Eosine Yellowish-(YS) ; Frozen Sections ; Hematoxylin ; Humans ; Immunohistochemistry ; Incidence ; Keratin-19 ; Keratins ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Prognosis ; Recurrence ; RNA, Messenger ; Sentinel Lymph Node Biopsy