No abstract available.
Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

No abstract available.
Krukenberg Tumor*

A 3 year and 3 months old boy with recurrent infections since his age of 5 months was presented with clinical data and autopsy findings. He was the 4th product of healthy parents. His elder brother died of recurrent perianal abscess and sepsis at his age of 3 years. His 2nd elder sister died on the 14th day of life probably from the complication of BCG vaccination. Beginnig with perianal abscesses at his age of 5 months, he has been continuously suffering from recurrent infections such as arthritis, ostomyelitis, pneumonia, epididymitis, subcutaneous abscesses and perianal abscesses. In spite of meticulous supportive and aggressive antibiotic therapy persistent positive cultures for staph. Aureus, klebsiella, E. Coli, Enterococcus and coliform bacilli from different sited were noted. Erythrocyte sedimentation rate of 25 to 40 were constant. White cell count varied frem 15500 to 33400 with polymorphonucleocytes predominance. NBT test showed persistent low scoring of 2% throught the course. He finally died of pneumonia and empyema. At postmortem examination, multiple abscesses and grnulomas of right lung and multipe granulomas in the liver, spleen, lymph node, bone, marrow, adrenal gland, kidney and intestinal wass were noted. At microscopic examination histiocytic granulomas with lipid containing histiocyte infiltrations were noted in every organs described including brain.
Abscess ; Adrenal Glands ; Arthritis ; Autopsy ; Blood Sedimentation ; Bone Marrow ; Brain ; Cell Count ; Empyema ; Enterobacteriaceae ; Enterococcus ; Epididymitis ; Granuloma ; Granulomatous Disease, Chronic* ; Histiocytes ; Humans ; Infant ; Kidney ; Klebsiella ; Liver ; Lung ; Lymph Nodes ; Male ; Mycobacterium bovis ; Parents ; Pneumonia ; Sepsis ; Siblings ; Spleen ; Vaccination

Human papillomavirus(HPV) has been implicated in the development of uterine cervical cancer. Detectioe of the small amounts of HPV DNA in cervical cells has been very difficult. The polymerase chain reaction(PCR) is a new technique that can specifically amplify target DNA to facilitate its detectiion. PCR technique wes used to detect HPV types 16 and 18 in cervical specimeas obtained from nnormal cervix(20 cases), dysplasia(25 cses), carcinoma in situ(21 cases), microinvasive cancer(ll cases), and invasive cancer(46 cases). And then, case of invasive carcinoma of the uterine cervix were analyzed to determine that the presence of specific human papillomavirus DNA in the neoplasm was a contributing factor to their outcome. The detection rate of HPV 16 DNA in normnal cervix, dysplasia, ClS, microinvasive cancer, and invasive squamous cell carcinoma were 50.0%, 36.0%, 81.0%, 45.5%, and 58.7%, respectively. The detection rate of HPV 18 DNA in normal cervix, dysplasia, CIS, microinvasive cancer, and invasive squamous cell carcinoma were 0.0%, 8,0%, 4.8%, 0.0%, and 19.6%, respectively. of the factors evaluated in invasive cervical cancer, adenocarcinomatous component(p= 0.004) and tumor grade(p=0.015) were found to be correlated with HPV l8 infection. 5 of 8 women whose tumors contained glandular elements had HPV 18 DNA, whereas only 4 of 38 women whose tumors contained only squamous elements showed this infection. 6 of 9 women of HPV l8 infected tumors were grade 3 tumors as compared to only 7 of 28 of HPV 16 infected tumors. Age at diagnosis and nodal status in relation to HPV type 18 exhibited a trend but were not statisitically significant. These observations suggest that HPV type 18 may be associated with a more aggressive form of cervical cancer than HPV type 16.
Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; DNA ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans* ; Polymerase Chain Reaction* ; Uterine Cervical Neoplasms*

BACKGROUND: Atherosclerosis is the most important disease that may cause ischemic syndrome in many organs including heart. It is supposed that apoptosis of vascular smooth muscle cells(VSMCs) is closely related to the progression and rupture of atheromatous plaque. Recent studies have documented evidence for elevated level of nitric oxide(NO) within advanced human atheroma and evidence of regression of atheroma by NO. So this study is designed to evaluate whether exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs and which proapoptotic gene(s) is involved in this type of apoptosis. METHODS: Rat VSMCs were cultured and used for experiment at passage 5 through 7. For NO donor, sodium nitroprusside (SNP) and S-nitroso-N-acetylpenicillamine(SNAP) of 0.5, 1, 2, 4mM were exposed to subconfluent VSMCs. The cells were harvested at 6, 12, 24, 48, 72hours after exposure of NO donors. Apoptosis was to be identified by 4, 6-diamidino-2-phenylindole dihydrochloride(DAPI) staining of nuclei and in-situ nick end labeling(TUNEL). The amount of fragmented DNA was analyzed semiquantitatively by diphenylamine(DPA) assay. Immunocytochemical(ICC) staining and western bolt analyses were designed to detect apoptosisrelated gene products, such as Bax-a, Fas and Bcl-2. RESULTS: 1) Decreased mitotic activity was shown after 12 hours exposure of exogenous NO donors, and condensation and margination of chromatin was identified agter 24 hours exposure, by DAPI staining. 2) Percent DNA fragmentation assessed by DPA method was 0,2,9,48,45% at 0,6,12,24,48 hours after exposure of 2mM of NO donors respectively. 3) The expression of Bax-a and Bcl-2 proteins was demonstrated in apoptotic cells by ICC staining. 4) The expression of Bax-a protein in cells under 24 hours exposure of NO donors was elevated by more than 18% of control level on densitometric analysis of western blot. The level of Bcl-2 was suppressed by 26% of control. So, Bax-a/Bcl-2 ratio in cells under exposure of NO donors was elevated to 2.0 from 1.2 of control level. CONCLUSIONS: Exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs, and it is considered that bax-a and bcl-2 genes are involved in this type of apoptosis.
Animals ; Apoptosis* ; Atherosclerosis ; Blotting, Western ; Chromatin ; DNA ; DNA Fragmentation ; Genes, bcl-2 ; Heart ; Humans ; Muscle, Smooth, Vascular* ; Nitric Oxide ; Nitroprusside ; Plaque, Atherosclerotic ; Rats* ; Rupture ; Tissue Donors

BACKGROUND: Amlodipine ; 2-<(2-aminoepoxi)methyl>-4-(2-chlorophenyl)-3-ethoxycarbonyl-5-methoxycarbonyl-6-methyl-1,2, dihydropyridine) is a novel calcium channel antagonist of long half-life and steady state blood levels. However, its blood pressure lowering effect throughout the day has not been well documented especially in Korean patients with essectial hypertension. Therefore, antihypertensive effect of amlodipine in Korean patients with mild to moderate hypertension was evaluated with using 24 hour ambulatory blood pressure measurement(ABPM) as well as office blood pressure measurement. METHODS: Total 25 subjects(M;F=13:12, mean age;53.4+/-7.3 yrs) with mild-to-moderate essectial hypertension had completed the study. After 2 weeks of placebo, amlodipine was mediciated for 12 weeks. Initially, amlodipine was given as 5mg once a day and the daily dose was increased to 10mg/day if diastolic blood pressure in over 90mmHg at the 8th week of medication. The blood pressure level was measured every 4weeks during medication in sitting position('office blood pressure level') and 24 hour ambulatory blood pressure monitoring(ABPM) was done at the placebo run-in phase and at the 8th week of medication. RESULTS: In the view of' office blood pressure lever', the blood pressure lowering effect of amlodipine was already impressive at 4 weeks after medication. The systolic(placebo; 165.3+/-16.9mmHg, arter 4 wk of medication; 136.1+/-16.0mmHg, 8 wk; 136.0+/-12.9mmHg, 12wk; 133.2+/-10.7mmHg) and diastolic blood pressure(placebo; 104.1+/-11.0mmHg,after 4 wk of medication; 87.4+/-6.8mmHg, 8 wk; 86.0+/-6.5mmHg, 12 wk; 84.7+/-5.4mmHg)fell significantly, and most patients had both satisfactory systolic(<160mmHg) and diastolic(<90mmHg) blood pressure levels. And such antihypertensive effects were main tained throughout study period. In contrast, the heart rate did not change significantly. The blood pressure lowering effects assessed by 24 hour AVPM were slightly milder, but absolute systolic and diastolic blood pressures by ABPM after 8 weeks of meddication were as low as those of office measurement. The blood pressure lowering effect was maintained throughout the day including morning periods without either rebound blood pressure elevation or reflex tachycardia. The percent reduction of systolc and diastolic vlood pressure with amlodipine were 17% in office blood pressure measurement and 10% in ABPM. During medication, neither significant side effects nor discomforts that lead to discontinuation of the drug has not been observed. Mild edmatous feeling in 3 subjects, flushing in one and palpitation in one were reported. CONCLUSION: Amlodipine is an effective antihypertensive drug that can control the elevated blood pressure in most patients with mild-to-moderate essential hypertension by monotherapy of once a day regimen without serious side effects.
Amlodipine* ; Blood Pressure* ; Calcium Channels ; Flushing ; Half-Life ; Heart Rate ; Humans ; Hypertension* ; Reflex ; Tachycardia

BACKGROUND: This study was designed to evaluate the clinical efficasy of lovastatin, HMG-CoA reductase inhibitor, in patients with hypercholesterolemia. METHODS AND RESULTS: Lovastatin 20 to 80 mg were administered once daily for 12 weeks in twenty five patients(11 male, 14 famale ; nine patients with familial hypercholesterolemia) with hypercholesterolemia(>240mg/dl). Compared with pretreatment levels, lovastatin significantly decreased levels of total cholesterol(309+/-46mg/dl versus 201+/-37mg/dl) by 35%, LDL-cholesterol(230+/-48mg/dl versus 125+/-40mg/dl) by 46% and triglyceride(170+/-76 versus 142+/-66mg/dl) by 11% (p<0.05) with significantly decreased levels of total-cholesterol/HDL-cholesterol ratio(7.4+/-2.1 versue 4.6+/-1.5) and LDL-cholesterol/HDL-cholesterol ratio(5.6+/-1.9 versue 2.9+/-1.4) (p<0.005 except triglyceride, respectively). The level of Apo B(183+/-32mg/dl versus 114+/-26mg/dl) was decreased significantly by 37%(p<0.005) with significantly decreased level of Apo A-1(115+/-22 to 122+/-26mg/dl) was increased significantly by 6%(p<0.05). No serious side effects were found. CONCLUSIONS: Results from the present study show that lovastatin is an effective and well-tolerated cholesterol-lowering agent.
Humans ; Hypercholesterolemia* ; Lovastatin* ; Male ; Oxidoreductases ; Triglycerides

OBJECTIVE: The aim of this study is to analyze the mitochondrial DNA in failing and normal hearts. METHODS: Genomic DNA was extracted from 18 failing and 4 normal hearts. The DNA was digested with each 50 units of BamH I, Pvu II, Pst I, and hybridized using DNA fragments encoding CO II (cytochrome oxidase II) and CO IU. They were detected using 'Fluorescein Gene Images' system. RESULTS: The light microscopic feature of failing myocardium was compatible with that of primary cardiomyopathy. In southern blot analysis, there was no significant difference in mitochondrial DNA amounts between normal and failing hearts. The amount of mitochondrial DNA in hearts, whether normal or failing, was greater than that in lymphocytes. There were no abnormal bands except 16.6kb-normal band using the enzyme BamH I, Pvu II from failing and normal hearts. After digesting with Pst I, 2.1kb band was found using probe CO II and 14.5kb band using probe CO III. CONCLUSION: The amount of mitochondrial DNA in hearts, whether normal or failing, was greater than that in lymphocytes, which suggests that the heart is an active organ in the energy metabolism. Abnormal band was not found in southern blot analysis of the mitochondrial DNA from failing and normal hearts. The more sensitive method such as PCR is required to detect the presence of sma11 amount of mutated DNA.
Blotting, Southern ; Cardiomyopathies ; DNA ; DNA, Mitochondrial* ; Energy Metabolism ; Heart Failure ; Heart* ; Lymphocytes ; Myocardium ; Oxidoreductases ; Polymerase Chain Reaction

BACKGROUND: Left ventricular remodeling after myocardial infarction is closely related to the prognosis of the patients with infarction and can be modified by angiotensin converting enzyme inhibitor. In experimental transmural infarction rat model, captopril decreases the ventricular compliance and simultaneously decrease the ventricular volume, but its effects on the nontransmurally infarcted heart are not elucidated. METHODS: Female Sprague-Dawley rats underwent 45-minute left coronary artery occlusion followed by reperfusion to produce nontransmural myocardial infarction. At 5 days after infarction, rats were randomized into two groups : untreated(n=8) and captopril-treated(captopril 2g/liter drinking water)(n=8). After 21 days of treatment, the hearts were arrested at diastole and excised. Passive pressure-volume curve of the left ventricle was plotted, and the stiffness modulus and mean compliance were calculated in the range of 5 to 30mmHg of pressure. Infarct size was also measured to confirm each group has similar size of lesion. The extent of fibrosis(relative area of fibrosis to randomly-selected peri-infarcted zone) was quantified on Masson's trichrome-stained ventricular slices by automatic image analysis software. RESULTS: Compared with untreated group, captopril-treated rats showed significantly decreased ventricular weight-to-body weight ratio(2.60+/-0.18mg/g vs. 2.84+/-0.20, p<0.05), decreased ventricular stiffness modulus(7.24+/-0.61 vs. 8.28+/-0.57, p<0.005), increased mean compliance(9.71+/-0.75 1/mmHg vs. 7.55+/-0.67, p<0.0001), and decreased fibrosis extent(0.82+/-1.49% vs. 5.53+/-5.33, p<0.01). CONCLUSION: These findings suggest that captopril increases the compliance of nontransmurally-infarcted left ventricle at least partly by the suppression of fibrosis, in contrast with previous findings that captopril decresed the passive compliance of transmurally-infarcted ventricle.
Animals ; Captopril ; Compliance ; Coronary Vessels ; Diastole ; Drinking ; Female ; Fibrosis ; Heart ; Heart Ventricles ; Humans ; Infarction ; Models, Animal ; Myocardial Infarction* ; Peptidyl-Dipeptidase A ; Prognosis ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Ventricular Remodeling*

BACKGROUND: Eisenmenger syndrome is a complication of heart dease with left-to-right shunt in which the pulmonary arterial pressure is increased due to increased pulmonary vascular resistance and the shunt directions becomes bidirectional or reversed at the level of atria, ventricies, or great arteries. Corrective surgery is impossible unless there is substantial reactive change pulmonary vascular resistance. METHOD: To identify clinical and hemodynamic features and observe natural history of adult patients with Eisenmenger syndrome, a retrospective clinical study was done on 61 patients(male:female=39:22) with Eisenmenger syndrome who were admitted to Seoul National University Hospital from September, 1979 to A piril, 1989, and were confirmed after cardiac catheterization and angiography. RESULTS: VSD was most freguent underlying defect(31 cases, 51%), followed by PDA(12 cases, 20%), ASD(9 cases,15%) and Combined lesion(9 cases, 15%). The average age was 27.3 years with the peak incidence in third decades. Effort intolerance(96.7%), palpitation(75.4%), hemoptysis(19.7%), and syncope(8.2%) were common symptoms, and cyanosis(62.3%), clubbing(63.9%) and increased heart sound were freguently(86.9%) observed. The mean pressure of the pulmonary artery and the total pulmonary vascular resistance were markedly elevated with the mean value of 76.7+/-14.2mmgHg and 29.3+/-12.HU respectively, 4 of the 19 patients who were given 100% oxygen inhalation showed reversibility of the pulmonary vascular resistance. During follow up(mean:40+/-29 months), Complications include infective endocarditis(1 case), brain abcess(2 case), atrial fibrillation(3 case), acute renal failure(1 case) and gout(2 case). 6 patients(10%) died during medical follow-up period(mean:40+/-29 months). Congestive heart failure and pulmonary infarction after cardiac catheterization including one postoprative death were causes of death. CONCLUSION: VSD, ASD, and PDA were common underlying defects of adult Eisenmenger syndrome. Complication was not uncommon and the common cause of death was congestive failure. The prognosis of the patients with Eisenmenger syndrome may not be so dismal as has been thought, though the exact survival to be determined.
Adult* ; Angiography ; Arterial Pressure ; Arteries ; Brain ; Cardiac Catheterization ; Cardiac Catheters ; Cause of Death ; Eisenmenger Complex* ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Heart ; Heart Failure ; Heart Sounds ; Hemodynamics ; Humans ; Incidence ; Inhalation ; Natural History* ; Oxygen ; Prognosis ; Pulmonary Artery ; Pulmonary Infarction ; Retrospective Studies ; Seoul ; Vascular Resistance