PURPOSE: To establish signal intensity characteristics of the trachea according to the histologic layers, we performed in vivo and in vitro MR studies. MATERIALS AND METHODS: We performed MR imaging of the trachea at 1.5T unit in 11 patients mediastinal masses, vascular anomalies, tracheal stenosis or iatrogenic tracheoesophageal fistula, aryepiglottic fold thickening or mass, tracheal carcinoid, one healthy volunteer and one cadaveric trachea. By using anterior, volume neck or 3 inch dual coil with various pulse sequences, axial and coronal images of the trachea were obtained. The tracheal layers with different signal intensity on MR images were correlated with the histology. RESULTS: In vivo and in vitro MR studies revealed two layers of the trachea ;the inner layer had intermediate to high signal and the outer had low signal. The tracheal cartilage showed low signal intensity in all pulse sequences. The submucosa appeared as intermediate signal intensity on T1 weighted images but high signal intersity on other images due to its abundant mucous and mucoserous glands. However, the mucosa and perichondrium could not be defined on MR images. CONCLUSION: Characterization of the signal intensity according to the histologic layers of the trachea might be helpful for the evaluation of intrinsic lesions of the irachea or the possibility of tracheal invasion from the adjacent tumors.
Cadaver ; Carcinoid Tumor ; Cartilage ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Mucous Membrane ; Neck ; Trachea ; Tracheal Stenosis ; Tracheoesophageal Fistula

No abstract available.
Barium* ; Enema* ; Intussusception*

No abstract available.

BACKGROUND: Pain is one of the most common presenting complaints in the emergency department(ED) and adequate analgesia for painful conditions is an important goal of emergency medical practice. This study was designed to investigate on the actual condition regarding the use of analgesic injections for traumatized patients in the field of ED and to reconsider the concern and methods of pain management in the future. METHOD: We carried out a prospective, noninterventional observational clinical study of adult patients presenting with acute trauma in the ED. Using a numeric rating scale ranging from 0 to 10, patients quantified their pain intensity on arriving at the ED and on one hour after analgesic administrations in the cases of analgesic use or after initial Assessment in the cases of no analgesic use. They also were interviewed about the level of their satisfaction to pain relief before leaving the ED. RESULTS: Seventy eight percent of all patient received analgesic injections(nonsteroidal antiinflammatory drugs; 62%, opioids; 16%) and the remaining 22 patients(22%) were treated without analgesics. At the time of secondary assessment to pain, initial pain score in the cases of analgesic administration decreased. Patients who are beyond fair in the level of satisfaction were recorded for only 18% of all patient even though 78% of patients received analgesic injections. CONCLUSION: Our data illustrate that the patient of trauma commonly receive analgesic injections in the ED but their levels of satisfaction are under fair. This finding suggests that the concern and methods of pain management have to be reconsidered through the understanding of analgesic pharmacology and pattern of pain relief by analgesics.
Adult ; Analgesia ; Analgesics ; Analgesics, Opioid ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Pain Management* ; Pharmacology ; Prospective Studies

BACKGROUND: Victims of trauma in the emergency room(ER) suffer from kinds of discomforts derived from their physical injury and psychological instability. Although discomforts may be varied by the patient's characteristics and environmental factors such as medical personnel or facilities in ER, an active control for the discomfort should be required because it may affect an outcome of treatment and prognosis of illness. The purpose of this study is to analyze the distressing factors which traumatized patients have been experienced in the ER and to improve the management of trauma patients in the future. METHODS: From January 1, 1996 to June 30, 1996, we tried to interview patients about the painful experiences in ER before the decision of his or her discharge from ER. We analyzed the data on age, sex, religion, educational level, injury severity score(ISS), the most unpleasant experience, sleep deprivation, and friar for death. RESULTS: The 126 patients were enrolled in this study. The patients consisted of 93 male and 33 female, their mean age was 45 years old and mean ISS was 7.86. About seventy one percent of the patients complained unpleasant experiences during the stay in the ER. Of these, pain at the injury sites was the most frequent complaint (66.7%). The sleep deprivation was showed about sixty percent of the total patient and the most common cause of this was also due to pain(40%). Nineteen percent of the patients answered that they have felt the fear for death. There were statistically significant differences in degree of the ISS whether the fear for death and unpleasant experience were or not. When the patients demarked with whether the presence of pain, the occurrence of sleep deprivation, and fear for death were statistically related to the pain. However, the data was denoted no direct relationship with pain according to sex, educational level, or religion. CONCLUSION: The trauma patient admitted to ER suffered from various stressful conditions including not only their physical injury but care personnel or unstable environmental factors in ER. Therefore, emergency medical personnel has to understand some possible distresses of the patients and need to reduce them to provide more careful and proper managements.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Sleep Deprivation

In 1989, the Bethesda System (TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia (CIN) and Papanicolaou Class System, which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion (SIL), subdivided into low-grade and high-grade types. TBS recommends a specific format for cytologic report, starting with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studies performed over last 10 years have provided evidence that human papillomavirus (HPV) plays a significant role in the development of cervical neoplasia. TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.
Azathioprine* ; Body Fluids ; Cadherins ; Cervical Intraepithelial Neoplasia ; Diagnosis ; Epidemiologic Studies ; Humans ; Immunohistochemistry ; Nephritis* ; Nephrotic Syndrome* ; Purpura, Schoenlein-Henoch*

To investigate effects of cytokines on rheumatoid synovial cells, proliferation and expression of cytokine and metalloproteinase genes were studied with the primary culture of rheumatoid synovial cells which was treated with TNF-alpha, GM-CSF, TGF-alpha, PDGF and IL-B. By [3H] thymidine incorporation assay, TGF-beta and PDGF increased proliferation of synovial cells by 1.5 and 2.5 folds respectively. Cytokine gene expression was assessed by RT-PCR. Rheumatoid synovial cells expressed constitutively TGF-beta and IL-B at a high level and IL-1B, GM-CSF, and MIP-1a at a relatively low level. TGF-beta, GM-CSF and PDGF increased IL-B expression. Expression of pro-inflammatory cytokines and chemokines was increased by GM-CSF and PDGF. Both GM-CSF and PDGF increased the expression of IL-1B, GM-CSF MIP-la and IL-8. In addition, GM-CSF enhanced expression of TNF-alpha. Stromelysin and collagenase are the major proteinases responsible for destruction ot joints in rheumatoid arthritis (RA). These genes were expressed constitutivefy in rheumatoid synovial cells. In summary, PDGF and GM-CSF may piay an important role by inducing or increasing expression of IL-1B, TGF-beta and PDGF by increasing proliferation of rheumatoid synovial cells.
Tumor Necrosis Factor-alpha

No abstract available.
Arteries* ; Heart Septal Defects, Ventricular*

Cytologic findings of pleural effusion in three cases of rhabdomyosarcoma are reported. Case 1 was a pleomorphic rhabdomyosarcoma which had devoped at the chest wall of an elderly male patient and caused pleural effusion. The cytologic features were consistent with pleomorphic rhabdomyosarcoma, that was, showing loose clusters, cellular pleomorphism, and abundant finely vesicular cytoplasm. Cases 2 and 3 were embryonal rhabdomyosarcomas in young adults. Primary site was the oral cavity in case 1, but unknown in case 2 and case 3. The effusion cytology was similar in these cases. Clustered or isolated small round cells with hyperchromatic nuclei and scanty cytoplasm were smeared. The cohesiveness of tumor cells was weak and the cells did not show linear arrangement or nuclear molding. Effusion cytology in a sarcoma patient would be diagnostic when the primary site and the type of sarcoma were already known.
Aged ; Cytoplasm ; Fungi ; Glomerulonephritis* ; Glomerulonephritis, Membranous* ; Humans ; Male ; Mouth ; Pleural Effusion ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal ; Sarcoma ; Thoracic Wall ; Young Adult

Transplant glomerulopathy is a late complication of renal transplantation. The characteristic morphology of transplant glomerulopathy includes thickening of glomerular capillary loops with double contour, and duplication of glomerular basement membrane on electron microscopy. Clinical and experimental evidences support the role of antibody-mediated immune mechanism in the development of transplant glomerulopathy. Antibody-induced endothelial cell injury is the key pathogenesis of transplant glomerulopathy. The evolution of transplant glomerulopathy in the context of immunologic injury is briefly reviewed.
Capillaries ; Endothelial Cells ; Glomerular Basement Membrane ; Graft Rejection ; Immunity, Humoral ; Kidney Glomerulus ; Kidney Transplantation ; Microscopy, Electron ; Transplants