Nitric oxide ( NO ) is now recognized as a mediator of several biological and immunological functions, but unlike classical neurotransmitters, NO simply diffuse of the postsynaptic cell and around affecting cells. Human chorionic gonadotropin ( hCG ), produced by placental trophoblasts may act as stimulator on NO synthesis in oocytes of mouse's ovary. How-ever, in the various organs or cells, the action of hCG on NO synthesis is unknown. We have examined that the effect of hCG on NO synthesis in microglial cells of murine's brain, using the Griess method. And this study was evident that hCG did not induce NO produc-tion without recombinant interferon gamma ( rIFN-gamma), whereas hCG ( 10~500 IU/ml ) with rIFN-gamma effectively produced NO in microglial cells of brain. As result, NO production in microglial cells increased most significantly in dose of 100 IU/ml of the hCG and the pro-duction of NO was dependent on the dose of hCG ( Table 1 and Fig. 1 ). And N(G)-monomethyl-L-arginine ( N(G)MMA ), competitive inhibitor of NO synthase, reduced the NO production by hCG stimulation with rIFN-gamma in microglial cells of murine. Conclusively, this study sugge-sted that hCG stimulate NO production at microglial cells in brain, which may be an important factor for mediating immune and neuroendocrinologic regulation in nervous system.
Brain ; Chorionic Gonadotropin* ; Female ; Humans* ; Interferons ; Negotiating ; Nervous System ; Neurotransmitter Agents ; Nitric Oxide Synthase ; Nitric Oxide* ; Oocytes ; Ovary ; Trophoblasts

No abstract available.
Lymph Nodes* ; Neoplasm Metastasis* ; Tomography, X-Ray Computed*

In performance of total hip replacement in the cases of acetabular deficiency, a few authors suggest cement inforcement with screws fixation or bone graft with resected femoral head for repair of it. In our cases another problem was loss of femoral head with acetabular deficiency, therefore resected femoral head could not be used. Our solution to this problem is to use the ilium, as a bone graft and to attach it to the acetabular wall to provide bone stock for the reconstruction. In six hips followed for over one year, all grafts appeared to be united and none showed evidence of resorption. All hips are functionally good and no case shows loosening.
Acetabulum ; Arthroplasty, Replacement, Hip ; Head ; Hip ; Ilium ; Transplants

No abstract available.
Colon* ; Colonic Neoplasms* ; Humans ; Sparganosis* ; Ultrasonography*

No abstract available.
Nevus*

The purpose of this study is to evaluate the results of the reconstruction of acetabular bone defect with morselized bone graft in revision of failed acetabular cup, used screw fixed hemispherical cup or bipolar cup as a component. Forty five revisions of an acetabular component that had been performed in 42 patients between 1988 and 1993 at SNUH, and had followed more than two years were included in this study. The revised acetabulum was evaluated by Harris hip score, in terms of osseous union and resorption of the graft, the amount of the migration of the revised components. Cup angle change and radiolucency were also evaluated in screw fixed hemispherical cup. The mean Harris hip score was improved 54 to 87 in screw fixed hemispherical cup and 56 to 78 in bipolar cup. In screw fixed hemispherical cup, osseous union showed within 6 months is 91.3% (21 cases), the graft bone resorption less than 10% of the initial graft thickness is 73.9% (17 cases). In bipolar cup, osseous union within 6 months is 52.2% (12 cases), the graft bone resorption less than 10% of the initial graft thickness is 40.9% (9 cases). The failure of revised acetabular component was five in bipolar cup cases and one in screw fixed hemispherical cup cases. In conclusion, screw fixed hemispherical cup showed better clinical results, earlier graft osseous union, less graft bone resorption and lower failure rate than bipolar cup. There was no significant difference between pure allograft mixed with autograft in clinical and radiological results. So we recommend the technique used morselized allograft with screw fixed hemispherical cup, to reconstruct the acetabular bone defect in acetabular cup revision, though bipolar cup was used in staged operation in severe acetabular bone defect with was unable to fix the acetabular cup with screws.
Acetabulum ; Allografts ; Autografts ; Bone Resorption ; Hip ; Humans ; Transplants

BACKGROUND: Balloon mitral valvuloplasty is a favorable procedure as a therapy for mitral stenosis because it minimizes morbidity and shorten hospital stay compared with surgical mitral commissurotomy or mitral valve replacement. Recent reports about concomitant transesophageal echocardiography guide in addition to fluoroscopy suggest that transesophageal echocardiograpy can provide additional benefits during balloon mitral valvuloplasty especially in transseptal puncture, balloon positioning, evaluation of immediate result, and early detection of complications. We performed this study to identify the potential benefits of on-line transesophageal echocardiography guide during balloon mitral valvuloplasty. METHOD: We performed balloon mitral valvuloplasty under on-line transesophageal echocardiography guide in addition to fluoroscopy in 70 patients(male:14, female:56, mean age:44+/-13) with rheumatic mitral stenosis from May 1995 to May 1996. Thirty-two(46%) patients had atrial fibrillation. Included patients were symptomatic with more than NYHA class 2 symptom. Patients with mitral valve score more than 11 and mitral regurgitation more than 2/4 were excluded. Inoue balloons were utilized in all cases. RESULTS: The average mitral valve area increased from 0.9+/-0.2cm2 before valvuloplasty to 1.8+/-0.4cm2 after valvuloplasty(p<0.0001). The averagetransmitral pressure gradient measured by continuous wave Doppler decreased from 14+/-6mmHg before valvuloplasty to 5+/-2mmHg after valvuloplasty(p<0.0001), and the average left atrial pressure measured by catheterization decreased form 22+/-8 mmHg before valvuloplasty to 11+/-5mmHg after valvuloplasty(p<0.0001). The average procedure time was 64+/-22 minutes(ranged from 13 to 150 minutes) and the average fluoroscopy time was 19+/-15 minutes(ranged from 1 to 94 minutes). Two patients underwent surgery due to severe mitral regurgitation associated with papillary muscle rupture which developed after valvuloplasty. In one patient, transesophageal echocardiography detected pericaridal tamponade during the procedure and the transducer was quickly switched to transthoracic transducer to guide the pericardial puncture site. The pericardial tamponade was drained with pigtail catheter and the patient underwent balloon mitral valvuloplasty successfully a week later. Four patients were pregnant at the time of the valvuloplasty procedure and the valvuloplasty was successfully performed with minimal fluoroscopy time(1-3 minutes) without complications in all four patients. Five patients had thrombus in left atrial appendage, but the transesophageal echocardiography was useful in monitoring the ballon position during the procedure and the valvuloplasty was successfully performed without embolic complications in all five patients. CONCLUSION: The transesophageal echocardiography is a very useful guiding adjunct during balloon mitral valvuloplasty in transseptal puncture, balloon positioning, evaluation of immediate result, early detection of complications, and shortening fluoroscopy time especially in pregnant women.
Atrial Appendage ; Atrial Fibrillation ; Atrial Pressure ; Cardiac Tamponade ; Catheterization ; Catheters ; Echocardiography, Transesophageal* ; Female ; Fluoroscopy ; Humans ; Length of Stay ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Papillary Muscles ; Pregnant Women ; Punctures ; Rupture ; Thrombosis ; Transducers

BACKGROUND: Percutaneous mitral balloon valvuloplasty(PMV) is a good treatment modality for patient with mitral stenosis(MS). But it is considered relatively contraindicated in patients with left artrial thrombi because of high risk of embolism. Limitted studies have suggested the feasibility of PMV in patients with left atrial appendage(LAA) thrombi. This study was performed to evaluate the feasibility and safty of PMV in patients with LAA thrombi using Inoue balloon under the transesophageal echocardiographic (TEE) monitoring. METHOD: PMV was performed in 5 patients diagnosed as MS with LAA thrombi from October, 1995 to July, 1996. Four cases were female, and one case was male. Their mean age was 525(46-58years old). Two of them had history of cerebrovascular accident(CVA). The duration of anticoagulant treatment was 6-49 moths. All patients underwent PMV using Inoue balloon catheter under the TEE monitoring. RESULTS: EKG finding of all 5 patients were atrial fibrillation(Af). Their mitral valve score were 5-10(Mean score was 82). Transmitral mean pressure gradient was decreased from 14.62.1 to 5.82.0mmHg, and mitral valve increased from 0.840.43 to 1.720.19 after PMV. There was no procedure related complication. In 3 cases of them LAA thrombi diappeared in the follow up TEE. In two patients, the LAA thrombi were calcified and remained unresolved at the time of follow up TEE( 6month-and 12 month-F/U, eath). CONCLUSION: Although the reported number of PMV in patients with LAA thrombi is small in this study, we believe that, with special precaution and TEE monitoring, LAA thrombi is no longer an absolute contraindication to PMV.
Atrial Appendage* ; Balloon Valvuloplasty* ; Catheters ; Echocardiography ; Electrocardiography ; Embolism ; Female ; Follow-Up Studies ; Humans ; Male ; Mitral Valve ; Moths

A 14-year-old female patient was seen with a nodular lesion on her left shoulder which developed one month after BCG vaccination. Physical examination revealed a thumb tip sized, irregular surfaced, erythematous scar-like plaque on the left shoulder, and a 2.5cm diameter, movable, subcutaneous nodule without surface change on the left axilla. Histopathologic examination of the plaque on the left shoulder and axillary nodule showed tubercles composed of mononuclear cells, epithelioid cells and giant cells of the Langhans type in the dermis. Caseation necrosis within the typical tubercles was noted. Prominent resolution of the lesion was observed 4 months after oral medication with isoniazid and ethambutol. The subcutaneous axillary nodule which developed after BCG vaccination was thought to be an unusual manifestation of skin tuberculosis.
Adolescent ; Axilla ; Dermis ; Epithelioid Cells ; Ethambutol ; Female ; Giant Cells ; Humans ; Isoniazid ; Mycobacterium bovis* ; Necrosis ; Physical Examination ; Shoulder ; Skin* ; Thumb ; Tuberculosis, Cutaneous* ; Vaccination*

No abstract available.