No abstract available.
Endocarditis*

Mural nodules in ovarian mucinous tumors, whether benign, borderline, or malignant, have been described by several authors since Prat and Scully first described sarcoma or sarcoma-like mural nodules occurring in association with mucinous epithelial neoplasia in 1979. Three distinct types of the mural nodule have been identified; i. e., 1) sarcoma-like lesion, 2) true mesenchymal sarcome, and 3) anaplastic carcinoma simulating a sarcoma. Mural nodules of sarcomatous and carcinomatous foci associated with mucinous ovarian tumors should be separated from sarcoma-like nodules because of the poor prognosis of the former compared to the favorable prognosis of the latter. We experienced a case of ovarian mucinous cystadenocarcinoma with sarcoma-appearing mural nodule of anaplastic carcinoma occurred in a 59-year-old woman and reported with brief review of the literatures.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Middle Aged ; Mucins* ; Ovary ; Prognosis ; Sarcoma

Osteoid osteoma is a small, oval or roundish, nidus like neoplasm of bone. The lesion usually does not exceed a centimenter in its greatest dimension, and it consists of osteoid, trabeculae of newly formed osseous tissues and a substratum of highly vascularized osteogenic connective tissue. In a differential diagnosis, consideration should be given to Brodies abscess, sclerosing osteomyelitis of Garre, Fibrous dysplasia and healing fractures. From Janua 1960 to December 1980, we have seen and studied 18 cases of osteoid osteoma and the results obtained from this study were follows: l. Eleven cases were found in second decade and 17 cases were developed before thirty years old. 2. The sex ratio was nearly equal and duration of disease from onset was average 16 months. 3. Location of lesions were predominantly in lower extremities, 9 in tibia and 3 in femur. 4. Pain was noted in 16 cases and aspirin affected in 8 cases. 5. Nidus was found in 11 cases. 6. All cases were treated by radical excision of lesions with disappearance of pain and satisfactory results.
Abscess ; Aspirin ; Clinical Study ; Connective Tissue ; Diagnosis, Differential ; Femur ; Lower Extremity ; Osteoma, Osteoid ; Osteomyelitis ; Sex Ratio ; Tibia

No abstract available.
Lung Diseases, Interstitial*

Elevated plasma level of the sulfur amino acid homocysteine, termed hyperhomocysteinemia, is now recognized as a contributing factor to various pathological states of the brain including vascular, degenerative and other neurologic disorders. Endothelial dysfunction may be one of the underlying mechanisms leading to proatherogenic and neurotoxic effects associated hyperhomocysteinemia. We conducted electron microscopic studies to investigate microvascular changes in hyperhomocysteinemic rat brain due to folate deficiency. Dietary folate deprivation caused an increase in plasma Hcy by 317% from 6.15 +/- 0.9 micro mol/l to 19.5 +/- 3.2 micro mol/l with time up to 8 weeks of folate deprivation. In electron microscopic study, perivascular amorphous fibrosis, and pericytic and endothelial cell degenerative appearance were frequently found in hyperhomocysteinemic microvasculature. These findings are very similar with the typical cerebral microvascular pathology observed in neurodegenerative and aging processes. From these results, it can be suggested that hyperhomocysteinemia -induced blood -brain barrier disruption give rise to subsequent neuronal dysfunction in hyperhomocysteinemia.
Aging ; Animals ; Brain ; Endothelial Cells ; Fibrosis ; Folic Acid ; Homocysteine ; Hyperhomocysteinemia* ; Microscopy, Electron ; Microvessels* ; Nervous System Diseases ; Neurons ; Pathology ; Plasma ; Rats ; Sulfur

PURPOSE: To evaluate anatomic variations and pitfalls of the labral-capsular-ligamentous complex in the shoulder joint for the proper interpretation of magnetic reasonance arthrographic images. MATERIALS AND METHODS:To determine the presence of sublabral sulci, undercutting of the base of the glenoid labrum by the articular cartilage, and the proximity of the middle glenohumeral ligament to the anterior glenoid labrum, 56 MR arthrograms of 41 asymptomatic volunteers were prospectively evalvated for labral shape and capsular insertion. We also evaluated the axillary fold, which was often confused with a loose body. RESULTS: The anterior and posterior parts of the labra, varied but their shape showed several dominant features; triangular(72%, 36%, respectively), rounded(13%, 35%), cleaved(8%, 1%), notched(2%, 0%), flat(5%, 24%), and absent(0%, 4%). Anterior capsular insertion was type 1 in 82% of cases, type 2 in 13% and type 3 in 5%, whereas posterior insertion was type 1 in 62%, type 2 in 36% and type 3 in 2%. We could also detect many pitfalls, such as undercutting of the base of theglenoid labrum by the articular cartilage(29%), sublabral sulci(25%), a prominent axillary fold(38%), and the middle glenohumeral ligament in proximity to the anterior labrum(5%). CONCLUSION: Our study revealed wide variability in the MR arthrographic appearance of the labral-capsular-ligamentous complex in asymptomatic shoulders. A good understanding of normal variation and pitfalls of the normal shoulder may be helpful pathologic condition in case of glenouhumeral instability.
Arthrography* ; Cartilage, Articular ; Ligaments ; Prospective Studies ; Shoulder ; Shoulder Joint ; Volunteers

PURPOSE: To evaluate the CT appearance of renal cell carcinoma and to correlate it with nuclear grading andcell type. MATERIALS AND METHODS: The size, outer margin and heterogeneity of inner texture of renal cell carcinomas in 86 patients were evaluated on CT scan and were correlated with nuclear grade and cell type. RESULTS: Tumors less than 5cm were of low grade in 28 of 31 patients, while those larger than 5cm were of low grade in 28 of 55 patients. The lesions which showed no or round protrusion with a sharp margin were of low grade in 26 of 28 patients, while those which showed an undulated or indistinct margin were of low grade in 30 of 58 patients. Lesions which showed a homogeneous solid appearance, focal low densities, or mostly cystic changes were of low grade in 23 of 26 patients, while those which showed multiple or confluent low densites were low grade in 33 of 60 patients. There was a significant difference in the distribution of nuclear grading between the groups. Differences in CT apperance according to cell type were not found. CONCLUSION: Differences in less than 5cm showing no or round protrusion with a sharp margin, homogeneous inner texture with solid appearance, and heterogeneous inner texture with cystic appearance or focal low densities on CT scan were thought to be the findings suggesting low nuclear grading.
Carcinoma, Renal Cell* ; Humans ; Population Characteristics ; Tomography, X-Ray Computed

PURPOSE: To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. MATERIALS AND METHODS: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM for Windows . RESULTS: Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV. 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP. 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. CONCLUSION: The results demonstrated a correlation between stimulation at each acupoint with increase in rCBF to the corresponding brain areas.
Acupuncture Points* ; Acupuncture* ; Brain* ; Cerebellum ; Female ; Frontal Lobe ; Head ; Healthy Volunteers ; Humans ; Male ; Medicine, East Asian Traditional ; Needles ; Prefrontal Cortex ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: The main advantage of drug administration by target-controlled infusion (TCI) is that it allows rapid adjustments of blood concentrations to individual patients requirements. In this study, we tried to confirm the side effects, relation, safety range and minimum effective analgesic concentration (MEAC) of fentanyl at the effect site. METHODS: Sixty ASA physical status 1 or 2 patients (age: 20 - 50 years) undergoing orthopedic surgery with regional anesthesia were randomly allocated to one of three groups according to effect site concentration of fentanyl (1, 1.5, or 2 ng/ml, n = 20 for each group). Total infusion time, total amount of drugs, vital signs, muscular rigidity, respiratory depression, level of consciousness, nausea, vomiting and pruritus was investigated. Meanwhile, we evaluated the MEAC by checking the effect site concentration of fentanyl when the patient complained of pain following propofol-fentanyl-N2O anesthesia using a computer assisted continuous infusion (n = 30). RESULTS: Demographic data and averaging scores of each parameter showed no difference among groups. However, incidences tended to increase above 1.5 ng/ml except with rigidity in the 1.5 ng/ml fentanyl group. The MEAC of fentanyl was checked as 0.61 +/- 0.18 ng/ml. CONCLUSIONS: Estimated MEAC of fentanyl was 0.61 +/- 0.18 ng/ml. There were increased side effects and complaints of patients above 1.5 ng/ml. The optimal initial postoperative target concentration of fentanyl was considered as 1 ng/ml.
Analgesia* ; Anesthesia ; Anesthesia, Conduction ; Consciousness ; Fentanyl* ; Humans ; Incidence ; Muscle Rigidity ; Nausea ; Orthopedics ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vital Signs ; Vomiting

The purpose of this study was to investigate the ontogeny of oxytocin- and vasopressin-specific neurons in the supraoptic and paraventricular nuclei of the human fetal hypothalamus. Eight human fetuses, 17- to 22-week gestation, were used in this study. Tissues of fetal hypothalami were fixed with 10% neutral buffered formalin, embedded in paraplast, and cut serially in coronal planes. Representative sections were stained with cresyl violet for the contour of both nuclei and monoclonal antibodies to oxytocin and vasopressin were used for immunohistochemistry. In the hypothalamus, oxytocin- and vasopressin-specific neurons were first observed in a 18-week fetus. In the fetus oxytocin-specific neurons were observed in both supraoptic and paraventricular nucleus and vasopressin-specific neurons were observed only in the supraoptic nucleus. Both neurons were observed in both nuclei of the fetuses and after 19-week of gestation. In both nuclei, oxytocin-specific neurons predominate in number in each stages. The shape of two cell types was mostly oval, and no significant differences of the size between two in each stages.
Antibodies, Monoclonal* ; Fetus* ; Formaldehyde ; Humans* ; Hypothalamus ; Immunohistochemistry ; Neurons* ; Oxytocin ; Paraventricular Hypothalamic Nucleus ; Pregnancy ; Supraoptic Nucleus ; Vasopressins ; Viola