No abstract available.
Doxycycline*

BACKGROUND: There is considerable controversy about the exact molecular mechanisms of excitatory amino acid receptors in epileptogenesis. METHODS: We used in situ hybridization to examine the hybridization density (HD) of n-methyl- D-aspartic acid receptor type 1 (NMDAR-1) and alpha-amino-3-hydroxy -5-methyl-4-isoxazole-propionate (AMPA) receptor type 2 (GluR-2) mRNA, in the hippocampus obtained from the kainic acid (KA)-induced status epilep-ticus (SE) model. Some Sprague-Dawley rats were injected with KA (10 mg/Kg; I.p.), and others with MK-801 (4 mg/kg) 20 minutes prior to KA. The rats were allowed to have 4-hour SE and were killed at 8 hours or 4 weeks after KA or MK-801/KA injection. HD of NMDAR-1 and GluR-2 mRNA in subfields of the hippocampus was measured by an image analysis system. RESULTS: A typical neuropathological finding of hippocampal sclerosis and spontaneous repetitive seizures (SRS) were observed in the KA injected rats, but not in the MK-801 pretreated rats, killed at 4 weeks. Compared with controls, the rats killed at 8 hours after KA showed increased CA1, CA2, and CA3 NMDAR-1 HD, and stratum granulosum (SG) GluR-2 HD. The increase of NMDAR-1, not GluR-2, HD was blocked effectively by MK-801. The increase of SG GluR-2 HD remained until 4 weeks after the KA injection. CONCLUSIONS: Not only the NMDAR-1activa-tionbut also the GluR-2 activation is an important factor in delaying hippocampal neuronal loss and epileptogenesis. (J Korean Neurol Assoc 19(1):36~44, 2001
alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; D-Aspartic Acid ; Dizocilpine Maleate ; Epilepsy, Temporal Lobe ; Gene Expression* ; Glutamic Acid* ; Hippocampus ; In Situ Hybridization ; Kainic Acid ; N-Methylaspartate ; Neurons ; Rats ; Rats, Sprague-Dawley ; Receptors, Glutamate* ; RNA, Messenger ; Sclerosis ; Seizures ; Temporal Lobe*

Pseudomyxoma peritonei is a rare disorder chracterized by abdominal distension resulting from the accumulation of a mucinous, gelatinous, translucent material which arises from rupture of pre-existing mucinous cystadenomas and cystadenocarcinomas of the ovary and mucocele of the appendix. We report 11 cases of pseudomyxoma peritonei which were diagnosed by surgical and pathological findings. The results were as follows. 1) The mean age of 11 cases was 51 years and 5 cases were male and 6 cases were female and male to female ratio was 1 to 1.2. 2) Clinical manifestations in 11 cases were abdominal distension in 5 cases (45.5%), palpable mass in 4 cases(36.6%), abdominal pain in 4 cases(36.6%), nausea in 3 cases(27.3%), weight loss in 3 cases(27.3%), diarrhea in 2 cases(18.2%), constipation in 1 case(9.0%), anal bleeding in 1 case(9.0%) and defecation difficulty in 1 case(9.0%). The duration of symptoms was 2 days to 1 year. 3) The primary sites of pseudomyxoma peritonei were ovarian cancer in 3 cases(27.2%), appendiceal cancer in 2 cases(18.2%), gastric cancer in 2 cases(18.2%), rectal cancer in 1 case(9.1%), cecal cancer in 1 case(9.1%) and unknown origin in 2 cases(18.2%). 4) Following surgical interventions were performed; right hemicolectomy in 2 cases, palliative gastrojejunostomy in 2 cases, oophorectomy in 1 case, omentectomy in 1 case and right hemicolectomy with gastrojejunostomy in 1 case. 5) The adjunctive anti-cancer chemotherapy was done in 4 cases(36.4%) by combination of actinomycin D, adriamycin, CCNU, cisplatin, cytoxan and fluorouracil, And chemotherapy only was done in 2 cases and hyperthermia was done in 1 case.
Abdominal Pain ; Appendiceal Neoplasms ; Appendix ; Cecal Neoplasms ; Cisplatin ; Constipation ; Cyclophosphamide ; Cystadenocarcinoma ; Cystadenoma, Mucinous ; Dactinomycin ; Defecation ; Diarrhea ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Fluorouracil ; Gastric Bypass ; Gelatin ; Hemorrhage ; Humans ; Lomustine ; Male ; Mucins ; Mucocele ; Nausea ; Ovarian Neoplasms ; Ovariectomy ; Ovary ; Pseudomyxoma Peritonei* ; Rectal Neoplasms ; Rupture ; Stomach Neoplasms ; Weight Loss

Endoscopic variceal ligation (EVL) is effective for the management of bleeding esophageal varices, and its use is widespread now. EVL necessitates the use of overtubes. Two primary techniques have been used for overtube placement; one is with endoscope, and the other is with bougie dilator. Overtube placement with endoseope is not without risk. There are reportd of esophageal or pharyngeal laceration or perforation. Overtube placement with bougie dilator circumvents this risk, but it is rather cumbersome to use. The authors devised a safe and easy method for overtube placement, and applied it to a number of patients to test its safety and convenience. First, overtube-dilator assembly was prepared as follows. A Rigiflex achalasia dilator (balloon 30mm OD, 10cm length; Microvasive Co) was lubricated and inserted into the overtube. A tenth of the balloon tip was protruded out of the overtube, then the balloon was insufflated with air at 10-15 psi. Second, standard endoscopy was performed, followed by placement of guide wire in the stomach. Overtube-dilator assembly was lubricated and introduced over the wire as a rail. Once the overtube was properly positioned, the balloon was deflated, and the balloon and wire were removed as a whole, which completed overtube placement. For 65 patients with esophageal variceal bleeding, 82 procedures of EVL were performed using the new technique. Overtube-dilator assembly was easy to prepare and handle. This technique added little time to the procedure and minimizes patients discomfort. No patient suffered major complications such as bleeding, laceration or perforation. This novel method for overtube placement was safe and convenient for use in EVL. It can also be applied to other procedures using overtube such as endoscopic foreign body removal.
Endoscopes ; Endoscopy ; Esophageal Achalasia ; Esophageal and Gastric Varices ; Foreign Bodies ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Stomach

Background: A decrease in computed tomography (CT)-derived skeletal muscle radiodensity (SMD) reflects age-related ectopic fat infiltration of muscle, compromising muscle function and metabolism. We investigated the age-related trajectory of SMD and its association with vertebral trabecular bone density in healthy adults. Methods: In a cohort of healthy adult kidney donors aged 19 to 69 years (n=583), skeletal muscle index (SMI, skeletal muscle area/height2), SMD, and visceral-to-subcutaneous fat (V/S) ratio were analyzed at the level of L3 from preoperative CT scans. Low bone mass was defined as an L1 trabecular Hounsfield unit (HU) <160 HU. Results: L3SMD showed constant decline from the second decade (annual change –0.38% and –0.43% in men and women), whereas the decline of L3SMI became evident only after the fourth decade of life (–0.37% and –0.18% in men and women). One HU decline in L3SMD was associated with elevated odds of low bone mass (adjusted odds ratio, 1.07; 95% confidence interval, 1.02 to 1.13; P=0.003), independent of L3SMI, age, sex, and V/S ratio, with better discriminatory ability compared to L3SMI (area under the receiver-operating characteristics curve 0.68 vs. 0.53, P<0.001). L3SMD improved the identification of low bone mass when added to age, sex, V/S ratio, and L3SMI (category-free net reclassification improvement 0.349, P<0.001; integrated discrimination improvement 0.015, P=0.0165). Conclusion L3SMD can be an early marker for age-related musculoskeletal changes showing linear decline throughout life from the second decade in healthy adults, with potential diagnostic value for individuals with low bone mass.

The Changes of soluble Fas levels in Patients with Autoimmune Thyroid Diseases BACKGROUD: Apoptosis was observed in thyroid tissue from Hashimoto disease but not those from Graves disease. Recently Fas and Fas ligand interactions among thyrocytes were suggested to development of clinical hypothyroidism in Hashimoto disease.Soluble Fas produced as the form lacking the tranmembrane domain due to alternative splicing, is supposed to inhibit Fas-Fas ligand interaction and blocks Fas mediated apoptosis. METHODS: In tbis study, we measured serum soluble Fas to determine the possible involvement of this molecule in the autoimmune thyroid disease by enzyme linked immunosorbant assay in 29 patients with Graves disease, 30 patients with Hashimotos disease and 19 normal controls. RESULTS: Compared with normal subjeets (4.26 +/- 1.00 U/mL), soluble Fas was not increased in patients with Graves disease (4.23 +/- 1.14 U/mL, p>0.05) but it was increased in throtoxic Graves patients (4.70 +/- 1.26 U/mL, p<0.05) compared to euthyroid Graves (3.72 +/- 0.73 U/mL, p<0.05) and normal subjects (4.26 +/- 1.00 U/mL, p<0.05). The euthyroid and hypothyroid patients with Hashimoto disease showed low soluble Fas levels, 2.94 +/- 0.54 U/mL and 2.74 U/mL, respectively compare to the patients with Graves disease and normal subjects. The thyroid hormone levels to (T3 T4 and free T4) showed positive correlation with the serum titers of antithyroid autoantibodies, antithyroglobuin antibodies, antiperoxidase antibodies and thyrotropin binding inhibitor immunoglobulins. CONCLUSION: We found that the patients with thyrotoxic Graves disease had increased level of serum soluble Fas and the patients with Hashimoto disease showed low levels of soluble Fas compared to normal controls. Increased soluble Fas in Graves disease suggests increased expression of alternatively spliced Fas mRNA variant and decreased soluble Fas in Hashimoto disease suggests decreased Fas mRNA variant and increased full length membrane Fas, so these findings are related to the promotion of apoptosis of thyroid cells during autoimmune reaction in Hashimotos disease.
Alternative Splicing ; Antibodies ; Apoptosis ; Autoantibodies ; Fas Ligand Protein ; Graves Disease ; Hashimoto Disease ; Humans ; Hypothyroidism ; Immunoglobulins ; Membranes ; RNA, Messenger ; Thyroid Diseases* ; Thyroid Gland* ; Thyrotropin

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis

Early gastric cancer(EGC) is defined as carcinoma limited to the mucosa or submucosa, regardless of whether metastasis to lymph nodes have occurred, and the frequency of lymph node metastasis varies from 7 to 18%. The incidence of early gastric cancer has been increasing recently, probably with advance in the diagnostic procedure. Multiple gastric cancer, now cosidered to be a sort of multiple primary cancer by Moertels classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Multiple carcinoma was found in about 8.3% of 500 early gastric cancer cases at the National Cancer Center Hospital in Japan. In 77% of these, two lesions roexisted in the stomach. Coexistence of three lesions were found in 20% and more than four lesions in 3%. We report a case of multiple early gastric cancer of different histologic types in which two adenoma coexisted in the stomach.
Adenoma ; Classification ; Incidence ; Japan ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms*

Early gastric cancer(EGC) is defined as carcinoma limited to the mucosa or submucosa, regardless of whether metastasis to lymph nodes have occurred, and the frequency of lymph node metastasis varies from 7 to 18%. The incidence of early gastric cancer has been increasing recently, probably with advance in the diagnostic procedure. Multiple gastric cancer, now cosidered to be a sort of multiple primary cancer by Moertels classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Multiple carcinoma was found in about 8.3% of 500 early gastric cancer cases at the National Cancer Center Hospital in Japan. In 77% of these, two lesions roexisted in the stomach. Coexistence of three lesions were found in 20% and more than four lesions in 3%. We report a case of multiple early gastric cancer of different histologic types in which two adenoma coexisted in the stomach.
Adenoma ; Classification ; Incidence ; Japan ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms*